Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2021; 13(9): 1017-1028
Published online Sep 15, 2021. doi: 10.4251/wjgo.v13.i9.1017
Association between intestinal neoplasms and celiac disease: A review
Man Wang, Ming Yu, Wen-Jie Kong, Mei Cui, Feng Gao
Man Wang, Wen-Jie Kong, Feng Gao, Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Ming Yu, Department of General Practice, Xiangyang Central Hospital, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441021 Hubei Province, China
Mei Cui, Department of Pathology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Author contributions: Wang M and Gao F designed the study; Wang M and Yu M acquired the data and drafted the article; Wang M and Yu M contributed equally to this work; Cui M and Gao F revised the article critically for important intellectual content; All the authors approved the version to be published.
Supported by The National Natural Science Foundation of China, No. 81760101.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Feng Gao, MD, PhD, Chairman, Professor, Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Tianshan District, Urumqi 830001, Xinjiang Uygur Autonomous Region, China.
Received: February 22, 2021
Peer-review started: February 22, 2021
First decision: May 8, 2021
Revised: June 2, 2021
Accepted: July 30, 2021
Article in press: July 30, 2021
Published online: September 15, 2021

Celiac disease (CD) is a chronic immune-mediated intestinal disease with genetic susceptibility. It is characterized by inflammatory damage to the small intestine after ingestion of cereals and products containing gluten protein. In recent years, the global prevalence rate of CD has been approximately 1%, and is gradually increasing. CD patients adhere to a gluten-free diet (GFD) throughout their entire life. However, it is difficult to adhere strictly to a GFD. Untreated CD may be accompanied by gastrointestinal symptoms, such as diarrhea, abdominal pain, and extraintestinal symptoms caused by secondary malnutrition. Many studies have suggested that CD is associated with intestinal tumors such as enteropathy-associated T-cell lymphoma (EATL), small bowel cancer (SBC), and colorectal cancer. In this study, we reviewed related studies published in the literature to provide a reference for the prevention and treatment of intestinal tumors in patients with CD. Compared with the general population, CD patients had a high total risk of SBC and EATL, but not colorectal cancer. The protective effect of GFD on CD-related malignancies is controversial. Further studies are needed to confirm whether GFD treatment can reduce the risk of intestinal neoplasms in CD.

Keywords: Celiac disease, Gluten-free diet, Intestinal neoplasms, Small bowel cancer, Enteropathy-associated T-cell lymphoma, Colorectal cancer

Core Tip: Celiac disease (CD) is an autoimmune intestinal disease caused by intake of gluten-containing cereals and their products by individuals with genetic susceptibility genes. The global prevalence rate is approximately 1% and is gradually increasing. CD can lead to intestinal mucosal damage and secondary malnutrition caused by extraintestinal symptoms. In this study, the total risk of small bowel cancer and enteropathy-associated T-cell lymphoma in CD patients was higher than that in the general population, but the risk of colorectal cancer in CD patients was not significantly higher. The protective effect of a gluten-free diet on CD-related malignancies is controversial.