Celiac Disease and Colon Cancer Risk

colonoscopy appointment calendar
Catherine Lane/Getty Images

Does celiac disease affect your odds of developing colon cancer?

Colorectal cancer (cancer of the colon or the rectum) is the fourth-leading cause of cancer deaths in the United States. You might think that having celiac disease—a condition that affects your gastrointestinal system—would increase your odds of developing colon cancer or rectal cancer, but you'd be wrong. The evidence suggests otherwise.

The Facts on Celiac Disease and Colon Cancer

When it comes to colorectal cancer, several factors will raise your risk, including having inflammatory bowel disease (IBD), having a personal or family history of colon or rectal cancer or intestinal polyps, smoking, or eating a poor diet low in fruit and vegetables.

However, the available medical studies show that having celiac disease does not appear to increase your risk of colorectal cancer.

Clinicians writing in 2009 in the World Journal of Gastroenterology analyzed the available studies and reported that most show the risk of colorectal cancer in people with celiac disease is similar to that of the general population. One study did indicate a slightly heightened overall risk, but most did not.

In addition, people with celiac disease don't appear to develop more intestinal polyps (which can lead to colon cancer) than their non-celiac counterparts.

A study published in 2010 by Columbia University's Celiac Disease Center looked at all diagnosed celiac disease patients who underwent a colonoscopy during a nearly four-year period and then compared them to similar patients without celiac disease.

The study found at least one polyp in 13% of people with celiac (most of whom likely were following the gluten-free diet) and 17% of those without celiac disease.

Older patients and men—regardless of whether they had celiac or not—were more likely to have polyps.

Celiac Disease May Protect Against Colon Cancer

There's even more good news. Some of the researchers who have studied this issue speculate that celiac disease—especially if it's undiagnosed or if the person in question isn't following the gluten-free diet—may, in fact, protect against colorectal cancer.

Since medical research has indicated that a low-fiber, high-fat diet can increase your risks for colorectal cancer, the intestinal damage found in celiac disease may help mitigate that increased risk by preventing your body from absorbing fat. Alternatively, researchers say, immunological changes in the small intestines may inhibit development of cancer further down the line, in the colon.

Still, much more research is needed to determine the effects of celiac disease and the gluten-free diet on your risk of colorectal cancer. Remember, even if celiac disease doesn't affect your colon cancer risk, colon cancer is still a pretty common cancer.

What About Other Cancers?

Overall, celiac disease does seem to raise your risk of certain cancers, although most of that increase involves very high odds of developing a particular type of non-Hodgkin lymphoma.

Fortunately, that type of lymphoma—known as enteropathy-associated T-cell lymphoma, or EATL—is incredibly rare. In fact, only one person in every million develops it. But EATL, which begins in the small intestine (not the colon), is quite dangerous if you do develop it.

As far as other cancers go, there are some studies indicating that celiac disease may lower your risk of developing breast cancer. In addition, some studies have found a decline in the risk of certain cancers for people with celiac disease who are following the gluten-free diet carefully and long-term. Learn more about your overall cancer risk if you have celiac disease.

A Word from Verywell

The information available right now on the risk of colon cancer if you have celiac disease is encouraging. However, there hasn't been enough research yet to conclusively determine how celiac disease and the gluten-free diet might truly impact your risk for colon cancer. And even if having celiac leads to a lower risk of colon cancer, it doesn't eliminate it entirely.

Fortunately, there are some things within your control that you can do to cut your risk for colon cancer: eat right, exercise and—most important of all—get screened.

Sources:

Centers for Disease Control and Prevention. Colorectal Cancer Risk Factors.

Freeman H.J. Malignancy in adult celiac disease. World Journal of Gastroenterology. 2009 Apr 7;15(13):1581-3.

Lebwohl B. et al. Risk of colorectal adenomas in patients with coeliac disease. Alimentary Pharmacology & Therapeutics. 2010 Oct;32(8):1037-43. doi: 10.1111/j.1365-2036.2010.04440.x. Epub 2010 Aug 17.

Continue Reading