title: Risk of cutaneous malignant melanoma in patients with celiac disease: a population-based study.
abstract: BACKGROUND
  Celiac disease (CD) carries an increased risk of several malignancies, including cancers of the gastrointestinal tract and hematologic malignancies. The disease course of cutaneous malignant melanoma (CMM) is affected by the immune status of the host, and therefore may be associated with CD.
  
  
  OBJECTIVE
  We sought to test for an association between CD and CMM in a population-based setting.
  
  
  METHODS
  We queried all (n = 28) pathology departments in Sweden and identified patients with intestinal histology consistent with CD. Each patient was matched to up to 5 control subjects by age, gender, calendar period, and region. Using Cox proportional hazards, we tested for an association between CD and the subsequent diagnosis of CMM.
  
  
  RESULTS
  Among patients with CD (n = 29,028), 78 subsequently developed CMM (0.3%). Compared with control subjects there was no significant association between CD and CMM (hazard ratio 0.94, 95% confidence interval 0.73-1.20). This null association was similar for men (hazard ratio 0.99, 95% confidence interval 0.68-1.44) and women (hazard ratio 0.89, 95% confidence interval 0.64-1.24), and in all age strata.
  
  
  CONCLUSIONS
  Lack of data regarding undiagnosed CD is a limitation.
  
  
  CONCLUSIONS
  In this population-based study we found no association between CD and the subsequent diagnosis of CMM. Prior studies showing a positive association between these 2 entities may have been a result of referral bias.
authors.affiliation: Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York; Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lebwohl
authors.affiliation: Department of Oncology-Pathology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Hanna
authors.initials: H
authors.lastname: Eriksson
authors.affiliation: Department of Oncology-Pathology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Hansson
authors.affiliation: Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Peter H R
authors.initials: PH
authors.lastname: Green
authors.affiliation: Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden. Electronic address: jonasludvigsson@yahoo.com.
authors.forename: Jonas F
authors.initials: JF
authors.lastname: Ludvigsson
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: celiac disease; melanoma