Risk of malignancy in patients with celiac disease

Green, Peter H. R.; Fleischauer, Aaron; Bhagat, Govind; Goyal, R. K.; Jabrì, Bana; Neugut, Alfred I.

doi:10.1016/s0002-9343(03)00302-4

Cited by 349 publications

(252 citation statements)

References 31 publications

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“…Furthermore, assessment of the level of non-adherence at which possible interventions would be deemed to be most beneficial is also problematic, as the potential individual and societal health benefit of small changes in gluten consumption is difficult to estimate. The risk of malignancy, for example, is now believed to be much lower than previously estimated and the influence of occasional non-adherence is unclear (Akobeng & Thomas, 2008;Catassi et al, 2007;Green et al, 2003;Haines, Anderson, & Gibson, 2008;Kaukinen et al, 1999;Silano et al, 2007). Diagnostic delay may have an influence on the likelihood of long term complications beyond treatment adherence (Silano et al, 2007) although the evidence for this is mixed (Haines et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Intentional and inadvertent non-adherence in adult coeliac disease. A cross-sectional survey

2013

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Publisher's copyright statement: NOTICE: this is the author's version of a work that was accepted for publication in Appetite. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be re ected in this document. Changes may have been made to this work since it was submitted for publication. A de nitive version was subsequently published in Appetite, 68, 2013Appetite, 68, , 10.1016Appetite, 68, /j.appet.2013 Additional information: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. ABSTRACTAdherence to a gluten-free diet is the mainstay of treatment for coeliac disease. Nonadherence is common as the diet is restrictive and can be difficult to follow. This study aimed to determine the rates of intentional and inadvertent non-adherence in adult coeliac disease and to examine the factors associated with both. A self-completion questionnaire was mailed to adult coeliac patients identified from the computer records of 31 family practices within the North East of England. We received 287 responses after one reminder. Intentional gluten consumption was reported by 115 (40%) of respondents. 155 (54%) had made at least one known mistaken lapse over the same period and 82 (29%) reported neither intentional nor mistaken gluten consumption.Using logistic regression analysis, low self-efficacy, perceptions of tolerance to gluten and intention were found to be independently predictive of intentional gluten consumption. A statistical model predicted 71.8% of cases reporting intentional lapses.Intentional non-adherence to the GFD was found to be common but not as frequent as inadvertent lapses. Distinguishing the factors influencing both intentional and inadvertent non-adherence is useful in understanding dietary self-management in coeliac disease.

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Section: Discussionmentioning

confidence: 99%

Intentional and inadvertent non-adherence in adult coeliac disease. A cross-sectional survey

2013

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“…Enteropathy-associated T-cell lymphoma is an aggressive disorder frequently associated with celiac disease [38,39]. Patients with celiac disease have an increased risk of various malignancies [38], including adenocarcinoma of the small bowel and diffuse large B-cell lymphoma.…”

Section: Enteropathy-associated T-cell Lymphomamentioning

confidence: 99%

“…Not all patients diagnosed with enteropathy-associated T-cell lymphoma have known celiac disease [39]. In a large international study of T-cell lymphomas, only one-third of the patients with enteropathyassociated T-cell lymphoma had previously been diagnosed with celiac disease [39].…”

Section: Enteropathy-associated T-cell Lymphomamentioning

confidence: 99%

The aggressive peripheral T‐cell lymphomas: 2015

Armitage

2015

American J Hematol

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Background: T‐cell lymphomas make up approximately 10%–15% of lymphoid malignancies. The frequency of these lymphomas varies geographically, with the highest incidence in parts of Asia.Diagnosis: The diagnosis of aggressive peripheral T‐cell lymphoma (PTCL) is usually made using the World Health Organization classification. The ability of hematopathologists to reproducibly diagnosis aggressive PTCL is lower than that for aggressive B‐cell lymphomas, with a range of 72%–97% for the aggressive PTCLs.Risk Stratification: Patients with aggressive PTCL are staged using the Ann Arbor Classification. Although somewhat controversial, positron emission tomography scans seem to be useful as they are in aggressive B‐cell lymphomas. The most commonly used prognostic index is the International Prognostic Index. The specific subtype of aggressive PTCL is an important risk factor, with the best survival seen in anaplastic large‐cell lymphoma—particularly young patients with the anaplastic lymphoma kinase positive subtype.Risk‐Adapted Therapy: Anaplastic large‐cell lymphoma is the only subgroup to have a good response to a CHOP‐like regimen. Angioimmunoblastic T‐cell lymphoma has a prolonged disease‐free survival in only ∼20% of patients, but younger patients who have an autotransplant in remission seem to do better. PTCL‐not otherwise specified is not one disease. Anthracycline‐containing regimens have disappointing results, and a new approach is needed. Natural killer/T‐cell lymphoma localized to the nose and nasal sinuses seems to be best treated with radiotherapy‐containing regimens. Enteropathy‐associated PTCL and hepatosplenic PTCL are rare disorders with a generally poor response to therapy, although selected patients with enteropathy‐associated PTCL seem to benefit from intensive therapy. Am. J. Hematol. 90:666–673, 2015. © 2015 Wiley Periodicals, Inc.

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“…Adenocarcinoma of the small intestine is a rare carcinoma and the risk for this carcinoma is increased in subjects with celiac disease. However, the absolute risk for this cancer is still quite low given its rarity (52). Patients may complain of abdominal pain and/or be found to have occult bleeding and further evaluation for this carcinoma should be considered in patients with celiac disease who develop these signs or symptoms after the resolution of the acute phase of their disease (5).…”

Section: Complications Of Celiac Diseasementioning

confidence: 99%

“…Patients may complain of abdominal pain and/or be found to have occult bleeding and further evaluation for this carcinoma should be considered in patients with celiac disease who develop these signs or symptoms after the resolution of the acute phase of their disease (5). Non-Hodgkin's lymphoma has also been reported to be increased in patients with celiac disease, although the absolute risk of disease is low (52), and at this time would not in itself justify the need for routine screening for celiac disease in the general population.…”

Section: Complications Of Celiac Diseasementioning

confidence: 99%