Association between intestinal neoplasms and celiac disease: A review

Abstract

Celiac disease (CD) is a chronic immune-mediated intestinal disease with genetic susceptibility. It is characterized by inflammatory damage to the small intestine after ingestion of cereals and products containing gluten protein. In recent years, the global prevalence rate of CD has been approximately 1%, and is gradually increasing. CD patients adhere to a gluten-free diet (GFD) throughout their entire life. However, it is difficult to adhere strictly to a GFD. Untreated CD may be accompanied by gastrointestinal symptoms, such as diarrhea, abdominal pain, and extraintestinal symptoms caused by secondary malnutrition. Many studies have suggested that CD is associated with intestinal tumors such as enteropathy-associated T-cell lymphoma (EATL), small bowel cancer (SBC), and colorectal cancer. In this study, we reviewed related studies published in the literature to provide a reference for the prevention and treatment of intestinal tumors in patients with CD. Compared with the general population, CD patients had a high total risk of SBC and EATL, but not colorectal cancer. The protective effect of GFD on CD-related malignancies is controversial. Further studies are needed to confirm whether GFD treatment can reduce the risk of intestinal neoplasms in CD.

Keywords: Celiac disease; Gluten-free diet; Intestinal neoplasms; Small bowel cancer; Enteropathy-associated T-cell lymphoma; Colorectal cancer

Core Tip: Celiac disease (CD) is an autoimmune intestinal disease caused by intake of gluten-containing cereals and their products by individuals with genetic susceptibility genes. The global prevalence rate is approximately 1% and is gradually increasing. CD can lead to intestinal mucosal damage and secondary malnutrition caused by extraintestinal symptoms. In this study, the total risk of small bowel cancer and enteropathy-associated T-cell lymphoma in CD patients was higher than that in the general population, but the risk of colorectal cancer in CD patients was not significantly higher. The protective effect of a gluten-free diet on CD-related malignancies is controversial.