Coeliac disease characteristics, compliance to a gluten free diet and risk of lymphoma by subtype

Dig Liver Dis. 2011 Nov;43(11):862-8. doi: 10.1016/j.dld.2011.07.012. Epub 2011 Aug 30.


Objective: Coeliac disease is associated with an increased risk of malignant lymphomas. We investigated the importance of coeliac disease characteristics and diet compliance for risk of lymphoma.

Methods: In a nested case-control design, we identified 59 patients with lymphoma and 137 matched controls from a population-based cohort of 11,650 inpatients with coeliac disease. We assessed coeliac disease characteristics at diagnosis and dietary compliance collected prospectively from medical records during follow-up.

Results: Poor compliance was not significantly associated with risk of lymphoma overall (odds ratio 1.83, 95% confidence interval 0.78-4.31) nor of lymphoma subtypes. Risk estimates differed by subtype; risk of T-cell lymphoma (odds ratio 1.01, confidence interval 0.32-3.15) or intestinal lymphoma (odds ratio 0.66, confidence interval 0.17-2.56) was unelevated, whereas there was an indication of a risk increase of B-cell lymphoma (odds ratio 4.74, confidence interval 0.89-25.3) or extraintestinal lymphoma (odds ratio 3.00, confidence interval 0.73-12.3) following poor compliance. History of weight loss (odds ratio 2.89, confidence interval 1.00-8.29) at coeliac disease diagnosis was associated with an increased risk of lymphoma when excluding tumours occurring with short latency (<3 years).

Conclusions: Compliance to a gluten-free diet did not significantly alter lymphoma risk, but a moderate effect cannot be excluded. Weight loss, a potential marker of coeliac disease severity, may be associated with lymphoma risk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Case-Control Studies
  • Celiac Disease / complications*
  • Celiac Disease / diagnosis
  • Celiac Disease / diet therapy*
  • Diet, Gluten-Free*
  • Female
  • Humans
  • Logistic Models
  • Lymphoma / epidemiology
  • Lymphoma / etiology*
  • Lymphoma, B-Cell / epidemiology
  • Lymphoma, B-Cell / etiology
  • Lymphoma, T-Cell / epidemiology
  • Lymphoma, T-Cell / etiology
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Compliance*
  • Prospective Studies
  • Risk Factors
  • Sweden / epidemiology
  • Weight Loss
  • Young Adult