As part of AP&T's peer-review process, a technical check of this meta-analysis was performed by Dr. P. Collins.
Meta-analysis: coeliac disease and the risk of all-cause mortality, any malignancy and lymphoid malignancy
Version of Record online: 13 JAN 2012
© 2012 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 35, Issue 5, pages 540–551, March 2012
How to Cite
Tio, M., Cox, M. R. and Eslick, G. D. (2012), Meta-analysis: coeliac disease and the risk of all-cause mortality, any malignancy and lymphoid malignancy. Alimentary Pharmacology & Therapeutics, 35: 540–551. doi: 10.1111/j.1365-2036.2011.04972.x
- Issue online: 3 FEB 2012
- Version of Record online: 13 JAN 2012
- Manuscript Accepted: 12 DEC 2011
- Manuscript Revised: 5 DEC 2011
- Manuscript Revised: 15 NOV 2011
- Manuscript Received: 20 OCT 2011
Coeliac disease has been associated with an increased risk of mortality and malignancy. However, the strength of this association is conflicting among different studies.
To perform a systematic review and quantitative meta-analysis to determine the risk of all-cause mortality, any malignancy and lymphoid malignancy in coeliac disease patients.
Four electronic databases (Medline, PubMed, Embase and Current Contents Connect) were searched to 4 January 2012, with no language restrictions. From 8698 citations identified, a total of 17 studies met our inclusion criteria.
The all-cause mortality meta-analysis showed an increased risk for all-cause mortality in coeliac patients [odds ratio (OR) 1.24; 95% confidence interval (CI) 1.19–1.30]. A subgroup analysis showed that patients identified by positive serology alone were also at an increased risk of all-cause mortality (OR 1.16; 95% CI 1.02–1.31). The non-Hodgkin lymphoma (NHL) meta-analysis showed an increased risk for NHL in coeliac patients (OR 2.61; 95% CI 2.04–3.33). A subgroup analysis showed that patients identified by positive serology alone were also at an increased risk of NHL (OR 2.55; 95% CI 1.02–6.36). The T-cell non-Hodgkin lymphoma (TNHL) meta-analysis showed an increased risk of TNHL (OR 15.84; 95% CI 7.85–31.94). The any malignancy meta-analysis showed no increased risk (OR 1.07; 95% CI 0.89–1.29).
Patients with coeliac disease are at an increased risk of mortality and non-Hodgkin lymphoma, particularly T-cell non-Hodgkin lymphoma; they do not have an increased risk of any malignancy overall. Serologically defined patients with coeliac disease have an elevated risk of mortality and non-Hodgkin lymphoma.