Celiac disease and risk of colorectal neoplasia

Although small bowel and esophagus neoplasia are recognized to occur more frequently in patients with celiac disease, the association with colorectal cancer is still controversial. To determine the risk of colorectal neoplasia among patients with celiac disease. A case-control study was conducted using the gastroenterology and endoscopy unit electronic data base. Patients with celiac disease and colonoscopy were regarded as cases and those without celiac disease and colonoscopy as controls. Patients were matched for age, sex, colonoscopy purpose and family history of colorectal cancer. The main outcome was the risk of colorectal polyps, adenomas, advanced lesions and cancer. The risk was expressed as odds ratio (OR) with the respective 95% confidence intervals (95% CI). Out of 178 celiac disease patients, 44 were included as cases. Eighty-eight non-celiac patients were included as controls. In cases, the presence of polyps, adenomas and advanced colonic lesions was 20%, 16% and 4.5%, respectively. In controls, it was 15%, 9% and3.4%, respectively. The risk of polyps, adenomas and advanced colonic lesions was similar in both groups: OR 1.48 (95% CI 0.59-3.73), OR 1.89 (95% CI 0.66-5.42) and OR 1.34 (95% CI 0.26-7.05). No colorectal cancer was identified. The risk of colorectal neoplasia within this cohort of patients with celiac disease was similar to the control population.