Clinical–Alimentary TractCancer incidence in a population-based cohort of individuals hospitalized with celiac disease or dermatitis herpetiformis*
Section snippets
Patients
In Sweden, all inpatient care for CD during the study period was public and population based, and referral patterns were almost solely based on geographic (rather than financial or other) determinants. The inpatient register contains individual-based information on Swedish inpatient care on a countywide level since 1964, and nationwide since 1987.24 For each hospitalization, the inpatient registry includes the patient's national registration number, unique to each citizen,25 dates of admission
Celiac Disease
Two hundred and forty-nine cancers occurred among those discharged with CD (SIR = 1.3, 95% CI: 1.2–1.5, Table 2).The relative risk declined with increasing length of follow-up evaluation. After 10 or more years of follow-up evaluation, the SIR was only slightly and nonsignificantly elevated (SIR = 1.1, 95% CI: 0.9–1.4, Figure 1).
Discussion
In this study, we showed that the overall cancer risk in a population-based cohort of individuals hospitalized with CD or DH over a 30-year period was only modestly elevated. In fact, in the first 5–10 years after initial hospitalization, no significant risk increase could be detected. Likewise, individuals first hospitalized as children or adolescents had no detectable increased cancer risk during their follow-up evaluation. Although we observed markedly elevated relative risks for malignant
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Address requests for reprints to: Johan Askling, M.D., Ph.D., Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute/Hospital, SE-171 76 Stockholm, Sweden. e-mail: [email protected].