Cancer is one of the biggest fears for celiac patients. Many studies have shown an increased risk of cancer for celiac patients in the first few years after diagnosis. After about 5 years of a gluten free diet, the risk of cancer moderates and is akin to non-celiac patients.

A recent study looked at hospitalization of celiac patients, cancers, length of hospital stay, and cost of hospital stay. The patients were admitted to the hospital due to celiac disease, no other cause. Researchers found an increased rate of small intestine, lymphoma, liver, skin, pancreatic, biliary, stomach, leukemia, uterus, and testis cancers. Celiac patients had a lower risk of respiratory cancers.

Researchers also noticed that celiac patients stayed longer and cost more than other patients with similar illnesses.

Also, researchers did offer a theory on how celiac patients develop lymphomas. The main hypothesis is immunity over activation, persistent inflammation, villous atrophy, and intestinal mucosal healing results in aberrant lymphocytes’ hyperproliferation. This can result in a possibility of malignant transformation of intraepithelial lymphocytes causing lymphomas.

This study does have some limitations. The study only looks at hospitalized patients and may not be appropriate to expand this data to outpatient populations. Researchers do not have details on the patient’s history. They can not confirm the patient’s celiac disease severity (Marsh levels) at diagnosis.

The biggest limitation to the study is that researchers can not asses a patient’s adherence to a gluten free diet. Nor can researchers know the degree to which their celiac disease is controlled.

As celiac patients, we have to be vigilant with our own health. Often, we only see a general practitioner or a gastroenterologist that may not be familiar with celiac disease. Doctors unfamiliar with the complexities of celiac disease may miss signs and symptoms of cancer. They may assume these symptoms are celiac side effects.