Colorectal Cancer in Biopsy-defined Celiac Disease Seen over 30 Years: Rare, Even in Elderly Adults

Some malignant disorders, including colorectal cancer (CRC), may be reduced in celiac disease. In this study, 154 older adults, including elderly adults over age 60 years, were seen over 30 years. All patients were biopsy-defined and treated with a gluten-free diet. A single elderly female had an early stage colon cancer in the cecum but a persistent iron deficiency anemia led to later detection of biopsy-defined celiac disease and a gluten-free diet mucosal response. This study indicates that colon cancer is rare in biopsy-defined celiac disease. In this study, there were no gastric, pancreatic or hepato-biliary tract cancers seen. Genetic and environmental dietary factors may play a role, however, the rarity of colorectal cancer in other celiac-associated colonic diseases (eg., collagenous or lymphocytic colitis) suggests that an immune-mediated protective effect may occur.