Published online Mar 15, 2023. doi: 10.4251/wjgo.v15.i3.523
Peer-review started: November 11, 2022
First decision: November 28, 2022
Revised: December 8, 2022
Accepted: February 10, 2023
Article in press: February 10, 2023
Published online: March 15, 2023
Celiac disease (CD) has been associated with gastrointestinal malignancies. However, the magnitude of the risk of pancreatic cancer (PC) associated with CD is much less clear, and risks have not been estimated from large populations.
To assess the risk of PC in CD patients.
We conducted a population-based, multicenter, propensity score-matched cohort study with consecutive patients diagnosed with CD using the TriNeTx research network platform. We examined the incidence of PC in patients with CD compared with a matched cohort of patients without CD (non-CD, controls). Each patient in the main group (CD) was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects. The incidence of PC was estimated using a Cox proportional hazards model with a hazard ratio (HR) and 95% confidence interval (CI).
A total of 389980 patients were included in this study. Among them, 155877 patients had a diagnosis of CD, and the remaining 234103 individuals without CD were considered a control cohort. The mean duration of follow-up for patients in the CD and control cohorts was 5.8 ± 1.8 and 5.9 ± 1.1 years, respectively. During the follow-up, 309 patients with CD developed PC, whereas 240 patients developed PC in the control group (HR = 1.29; 95%CI: 1.09-1.53). In the secondary analyses in the first year after diagnosis of CD, patients with CD were at a significant increase in risk for PC; 151 patients with CD had an incidence of PC compared with 96 incidences of PC among the patients in the non-CD control group (HR = 1.56; 95%CI: 1.20-2.01) and sensitivity analysis showed similar magnitude to the one generated in the primary and secondary analysis.
Patients with CD are at increased risk of PC. Risk elevation persists beyond the first year after diagnosis to reference individuals without CD from the general population.
Core Tip: Celiac disease (CD) is an immune-mediated disorder precipitated by the ingestion of gluten in genetically predisposed individuals. Population-based studies have shown the risk of cancer among patients with CD; however, the magnitude of the risk of pancreatic cancer (PC) in association with CD is much less clear. Therefore, In this multicenter retrospective cohort study, we analyzed the risk of PC in patients with CD. We examined the incidence of PC in patients with CD compared with a propensity-matched cohort of patients without CD. We found that patients with CD were at increased risk of PC. Risk elevation persisted beyond the first year after diagnosis to reference individuals without CD from the general population.