title: Delayed diagnosis of coeliac disease increases cancer risk.
abstract: BACKGROUND
  The association between coeliac disease (CD) and neoplasms has been long established, but few data are available about the risk factors. The aim of this paper is to estimate the risk of developing a neoplasm among non diagnosed coeliac patients and to evaluate if this risk correlates with the age of patients at diagnosis of coeliac disease.
  
  
  METHODS
  The study population consists of patients (n = 1968) diagnosed with CD at 20 Italian gastroenterology referral Centers between 1st January 1982 and 31st March 2005.
  
  
  RESULTS
  The SIR for all cancers resulted to be 1.3; 95% CI = 1.0-1.7 p < 0.001. The specific SIRs for non Hodgkin lymphoma was 4.7; 95% CI = 2.9-7.3 p < 0.001, for the small bowel carcinoma 25; 95% CI = 8.5-51.4 p < 0.001, for non Hodgkin lymphoma 10; 95% CI = 2.7-25 p = 0.01, finally for the stomach carcinoma 3; 95% CI = 1.3-4.9 p < 0.08. The mean age at diagnosis of CD of patients that developed sooner or later a neoplasm was 47,6 +/- 10.2 years versus 28.6 +/- 18.2 years of patients who did not.
  
  
  CONCLUSIONS
  Coeliac patients have an increased risk of developing cancer in relation to the age of diagnosis of CD. This risk results higher for malignancies of the gastro-intestinal sites. An accurate screening for tumors should be performed in patients diagnosed with CD in adulthood and in advancing age.
authors.affiliation: Division of Food Science, Human Nutrition and Health, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome, Italy. marco.silano@iss.it
authors.forename: Marco
authors.initials: M
authors.lastname: Silano
authors.forename: Umberto
authors.initials: U
authors.lastname: Volta
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Mecchia
authors.forename: Mariarita
authors.initials: M
authors.lastname: Dessì
authors.forename: Rita
authors.initials: R
authors.lastname: Di Benedetto
authors.forename: Massimo
authors.initials: M
authors.lastname: De Vincenzi
mesh_terms: D000328:Adult; D000367:Age Factors; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology*; D012042:Registries; D012306:Risk; D013997:Time Factors