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Malignancy and mortality in people with coeliac disease: population based cohort study

West, Joe ; Logan, Richard F A ; Smith, Chris J ; Hubbard, Richard B ; Card, Timothy R

BMJ, 2004-09, Vol.329 (7468), p.716-718 [Periódico revisado por pares]

London: British Medical Journal Publishing Group

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Título:
Malignancy and mortality in people with coeliac disease: population based cohort study
Autor: West, Joe ; Logan, Richard F A ; Smith, Chris J ; Hubbard, Richard B ; Card, Timothy R
Assuntos: Adolescent ; Adult ; Aged ; Autoimmune diseases ; Biological and medical sciences ; Breast cancer ; Cancer ; Celiac Disease - complications ; Celiac Disease - mortality ; Child ; Child, Preschool ; Cohort Studies ; Diabetes ; Digestive system diseases ; Disease risk ; Epidemiology ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastrointestinal diseases ; General aspects ; Health risk assessment ; Humans ; Infant ; Infant, Newborn ; Lung diseases ; Male ; Medical sciences ; Middle Aged ; Mortality ; Neoplasms - complications ; Neoplasms - mortality ; Other diseases. Semiology ; Primary Care ; Proportional Hazards Models ; Prostatic diseases ; Risk Factors ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Tobacco smoking ; United Kingdom - epidemiology
É parte de: BMJ, 2004-09, Vol.329 (7468), p.716-718
Notas: istex:D54FEAB378E1A8338055FFFE9C045DF83832F629
ArticleID:bmj.38169.486701.7C
Correspondence to: J West
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Funding: Wellcome Trust (grant No 063800).
Correspondence to: J West joe.west@nottingham.ac.uk
Ethical approval: Scientific and Ethical Advisory Group of the general practice research database.
We thank the staff of the Epidemiology and Pharmacology Information Core for their help with providing and formatting the data.
Contributors: JW designed the study and carried out most of the data management, analyses, interpretation, and writing of this study; he will act as guarantor for the paper. RFAL, CJS, RBH, and TRC contributed to the design, analyses, interpretation, and writing.
Competing interests: None declared.
Descrição: Abstract Objective To quantify the risks of malignancy and mortality in people with coeliac disease compared with the general population. Design Population based cohort study. Setting General practice research database. Participants 4732 people with coeliac disease and 23 620 matched controls. Main outcome measures Hazard ratios for malignancy and mortality. Results Of the 4732 people with coeliac disease, 134 (2.8%) had at least one malignancy and 237 (5.0%) died. The overall hazard ratios were: for any malignancy 1.29 (95% confidence interval 1.06 to 1.55), for mortality 1.31 (1.13 to 1.51), for gastrointestinal cancer 1.85 (1.22 to 2.81), for breast cancer 0.35 (0.17 to 0.72), for lung cancer 0.34 (0.13 to 0.95), and for lymphoproliferative disease 4.80 (2.71 to 8.50). The increased risk was primarily in the first year after diagnosis, with the risk for only lymphoproliferative disease remaining significantly raised thereafter. After excluding events in the year after diagnosis, the hazard ratio for malignancy was 1.10 (0.87 to 1.39) and for mortality was 1.17 (0.98 to 1.38), giving absolute excess rates of 6 and 17 per 10 000 person years, respectively. Conclusions People with coeliac disease have modest increases in overall risks of malignancy and mortality. Most of this excess risk occurs in the year of follow up after diagnosis. People with coeliac disease also have a noticeably reduced risk of breast cancer. The mechanism of this merits further attention as it may provide insights into the cause of this common malignancy.
Editor: London: British Medical Journal Publishing Group
Idioma: Inglês

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Malignancy and mortality in people with coeliac disease: population based cohort study

West, Joe ; Logan, Richard F A ; Smith, Chris J ; Hubbard, Richard B ; Card, Timothy R

London: British Medical Journal Publishing Group

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