Risk of colorectal neoplasia in patients with celiac disease: A multicenter study |
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| Institution: | 1. Digestive Endoscopy and Gastroenterology Services, Internal Medicine Department, Hospital Alemán, Buenos Aires, Argentina;2. Digestive Endoscopy and Gastroenterology Services, Internal Medicine Department, Hospital Italiano, Buenos Aires, Argentina;3. Digestive Endoscopy and Gastroenterology Services, Internal Medicine Department, Hospital CEMIC, Buenos Aires, Argentina;4. Digestive Endoscopy and Gastroenterology Services, Internal Medicine Department, Hospital Austral, Buenos Aires, Argentina;1. Dermatology Centre, University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, UK;2. Dermatology Department, York District Hospital, York, UK;1. IBD Unit, Gastroenterology and Hepatology Service, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain;2. Dermatology Service, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain;1. Inflammatory Bowel Disease Centre, Yokkaichi Social Insurance Hospital, Yokkaichi, Mie, Japan;2. Colorectal Surgery Unit, Cajuru University Hospital, Catholic University of Parana, Curitiba, PR, Brazil;1. Department of Internal Medicine, Hospital of Laredo, Laredo, Cantabria, Spain;2. Service of Gastroenterology, Hospital of Laredo, Laredo, Cantabria, Spain;3. Molecular Biology Laboratory, Service of Pathology, University Hospital Marqués de Valdecilla, Santander, Cantabria, Spain;1. Colorectal Surgery Unit, Cajuru University Hospital, Catholic University of Parana, Curitiba, PR, Brazil;2. Inflammatory Bowel Disease Center, Yokkaichi Social Insurance Hospital, Yokkaichi, Japan |
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| Abstract: | Background and aimsThe association of celiac disease with colorectal neoplasia is controversial. The aim of this study was to determine the risk of colorectal neoplasia among patients with celiac disease.MethodsWe carried out a multicenter, retrospective case–control study, within four community hospitals. Celiac disease patients with a complete colonoscopy were regarded as cases and those without celiac disease as controls. For each case, two controls matched for age, sex, indication for colonoscopy and colorectal cancer family history, were randomly selected. The main outcome evaluated was risk of colorectal polyps, adenomas, advanced neoplastic lesions and cancer.ResultsWe identified 118 patients with celiac disease and 236 controls. The risk of polyps, adenomas and advanced neoplastic lesions was similar in both groups (OR 1.25, CI 0.71–2.18, p = 0.40; OR 1.39, CI 0.73–2.63, p = 0.31; and OR 1.00, CI 0.26–3.72, p = 1.00, respectively). On multivariate analysis, age > 75 years old, and first-grade CRC family history were associated with adenomas (OR 2.68 CI 1.03–6.98, OR 6.68 CI 1.03–47.98 respectively) and advanced neoplastic lesions (OR 15.03, CI 2.88–78.3; OR 6.46 CI 1.23–33.79, respectively). With respect to celiac disease characteristic, a low adherence to a gluten free diet was independently associated with the presence of adenomas (OR 6.78 CI 1.39–33.20 p = 0.01).ConclusionsCeliac disease was not associated with an increased risk of colorectal neoplasia. Nonadherence to a strict gluten free diet was associated with the presence of adenomas. Further studies addressing celiac disease characteristics are needed to confirm this observation. |
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