In people with coeliac disease there is a small increased risk of intestinal malignancy. Undiagnosed coeliac disease is associated with an increased risk of non Hodgkin’s and Hodgkin’s lymphoma and small bowel cancer, but overall rates are low. It is recommended that serological testing should be offered to any children or adults with lymphoma.
Enteropathy associated T cell lymphoma (EATL)
EATL is a very rare type of non Hodgkin’s lymphoma affecting around 1 in a million people in the general population. It makes up less than 1% of all non-Hodgkin’s lymphomas. The main symptoms linked with EATL are gut problems including chronic diarrhoea, abdominal pain and unexplained weight loss. People with coeliac disease have a slightly higher risk of developing EATL because this affects the same part of the gut that is affected in coeliac disease. However, even with this slightly increased risk, overall the likelihood of developing this type of cancer is still very rare. Non adherence to a strict gluten free diet increases the risk of complications of coeliac disease including intestinal malignancy. Research suggests that the risk of intestinal malignancy decreases after ten years on a gluten free diet to nearly the same risk as in the general population.
There appears to be a lower risk of developing breast cancer and lung cancer in people with coeliac disease.