Risk of Small Bowel Adenocarcinoma, Adenomas, and Carcinoids in a Nationwide Cohort of Individuals With Celiac Disease

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Emilsson, Louise,1982-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Departments of General Practice and Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Vårdcentralen Årjäng and Centre for Clinical Research, County Council of Värmland, Värmland, Sweden (författare)

Risk of Small Bowel Adenocarcinoma, Adenomas, and Carcinoids in a Nationwide Cohort of Individuals With Celiac Disease

Artikel/kapitelEngelska2020

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American Gastroenterology Association Institute,2020
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LIBRIS-ID:oai:DiVA.org:oru-88359
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-88359URI
https://doi.org/10.1053/j.gastro.2020.07.007DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:145357887URI

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Språk:engelska
Sammanfattning på:engelska

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Funding Agency:The Louis and Gloria Flanzer Philanthropic Trust
BACKGROUND & AIMS: The incidence of small bowel cancers is increasing. Associations have been made between celiac disease (CD) and small bowel cancers, but there have been no detailed studies of large cohorts.METHODS: Through the nationwide Epidemiology Strengthened by Histopathology Reports in Sweden cohort study, we retrieved data from Sweden's 28 pathology departments on all individuals who received a diagnosis of CD from 1965 through 2017. Individuals with CD, defined as duodenal or jejunal villous atrophy (stage 3 Marsh score), were matched with as many as 5 randomly selected reference individuals from the general population. We used stratified Cox regression to calculate hazard ratios (HRs) for small bowel adenocarcinoma, adenomas, and carcinoids.RESULTS: During a median follow-up of 11 years, we identified 48,119 individuals with CD (patients) and 239,249 reference individuals. Beginning at 1 year after a diagnosis of CD, 29 patients (0.06%) received a diagnosis of small bowel adenocarcinoma vs 45 reference individuals (0.02%), 7 patients received a diagnosis of carcinoids vs 31 reference individuals, and 48 patients received a diagnosis of adenomas vs 50 reference individuals. Corresponding HRs were small bowel adenocarcinoma 3.05 (95% confidence interval [CI], 1.86-4.99), carcinoids 0.59 (95% CI, 0.16-2.10), and adenomas 5.73 (95% CI, 3.70-8.88). HRs were independent of sex and age. Overall, there was 1 extra case of small bowel adenocarcinoma in every 2944 patients with CD followed for 10 years. There was an inverse association between mucosal healing risk of future small bowel adenocarcinoma (HR, 0.18; 95% CI, 0.02-1.61), although the HR failed to attain statistical significance.CONCLUSIONS: In an analysis of a nationwide pathology database in Sweden, we found the absolute risk of small bowel adenocarcinoma is low in individuals with CD. However, risks of small bowel adenocarcinoma and adenomas (but not carcinoids) are significantly increased in people with CD compared to people without this disease.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Gastroenterologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Gastroenterology and Hepatology hsv//eng
Intestine
Neoplasm
Etiology
Gluten

Biuppslag (personer, institutioner, konferenser, titlar ...)

Semrad, CarolUniversity of Chicago Medicine, Chicago Illinois, USA (författare)
Lebwohl, BenjaminDepartment of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Medicine,Columbia University College of Physicians and Surgeons, New York NY, USA (författare)
Green, Peter H. R.Department of Medicine,Columbia University College of Physicians and Surgeons, New York NY, USA (författare)
Ludvigsson, Jonas F.,1969-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Medicine,Columbia University College of Physicians and Surgeons, New York NY, USA; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK(Swepub:oru)jsln (författare)
Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

Sammanhörande titlar

Ingår i:Gastroenterology: American Gastroenterology Association Institute159:5, s. 1686-16940016-50851528-0012

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Av författaren/redakt...: Emilsson, Louise ...; Semrad, Carol; Lebwohl, Benjami ...; Green, Peter H. ...; Ludvigsson, Jona ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Gastroenterologi

Artiklar i publikationen: Gastroenterology

Av lärosätet: Örebro universitet; Karolinska Institutet

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