title: Risk of colorectal neoplasia in patients with celiac disease: a multicenter study.
abstract: OBJECTIVE
  The 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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  We 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).
  
  
  CONCLUSIONS
  Celiac 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.
authors.affiliation: Digestive Endoscopy and Gastroenterology Services, Internal Medicine Department, Hospital Alemán, Buenos Aires, Argentina. Electronic address: lisandro_pereyra@hotmail.com.
authors.forename: Lisandro
authors.initials: L
authors.lastname: Pereyra
authors.forename: Raquel
authors.initials: R
authors.lastname: Gonzalez
authors.forename: Adriana
authors.initials: A
authors.lastname: Mohaidle
authors.forename: Carolina
authors.initials: C
authors.lastname: Fischer
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Mella
authors.forename: Guillermo Nicolás
authors.initials: GN
authors.lastname: Panigadi
authors.forename: Dante
authors.initials: D
authors.lastname: Manazzoni
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Matoso
authors.forename: Juan Sebastián
authors.initials: JS
authors.lastname: Lasa
authors.forename: Abel
authors.initials: A
authors.lastname: Novillo
authors.forename: Juan
authors.initials: J
authors.lastname: De Paula
authors.forename: Luis
authors.initials: L
authors.lastname: Soifer
authors.forename: Angel
authors.initials: A
authors.lastname: Nadales
authors.forename: Daniel Gustavo
authors.initials: DG
authors.lastname: Cimmino
authors.forename: Silvia
authors.initials: S
authors.lastname: Pedreira
authors.forename: Luis
authors.initials: L
authors.lastname: Boerr
mesh_terms: D000236:Adenoma / Q000453:epidemiology* / Q000235:genetics; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002446:Celiac Disease / Q000178:diet therapy / Q000453:epidemiology*; D003111:Colonic Polyps / Q000453:epidemiology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000235:genetics; D055050:Diet, Gluten-Free; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: ANL; CD; CI; CRC; Celiac disease; Colonic adenomas; Colonic polyps; Colorectal neoplasia; GFD; Malignancy; OR; advanced neoplastic lesions.; celiac disease; colorectal cancer; confidence interval; gluten free diet; odds ratio