Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York; Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Celiac disease (CD) carries an increased risk of several malignancies, including cancers of the gastrointestinal tract and hematologic malignancies. The disease course of cutaneous malignant melanoma (CMM) is affected by the immune status of the host, and therefore may be associated with CD.
We sought to test for an association between CD and CMM in a population-based setting.
We queried all (n = 28) pathology departments in Sweden and identified patients with intestinal histology consistent with CD. Each patient was matched to up to 5 control subjects by age, gender, calendar period, and region. Using Cox proportional hazards, we tested for an association between CD and the subsequent diagnosis of CMM.
Among patients with CD (n = 29,028), 78 subsequently developed CMM (0.3%). Compared with control subjects there was no significant association between CD and CMM (hazard ratio 0.94, 95% confidence interval 0.73-1.20). This null association was similar for men (hazard ratio 0.99, 95% confidence interval 0.68-1.44) and women (hazard ratio 0.89, 95% confidence interval 0.64-1.24), and in all age strata.
Lack of data regarding undiagnosed CD is a limitation.
In this population-based study we found no association between CD and the subsequent diagnosis of CMM. Prior studies showing a positive association between these 2 entities may have been a result of referral bias.