Does celiac disease increase your cancer risk?

This page was reviewed under our medical and editorial policy by

Toufic Kachaamy, MD, Chief of Medicine, City of Hope Phoenix

This page was reviewed on May 26, 2023.

When celiac disease isn’t kept under control by a gluten-free diet, it leads to widespread inflammation in the gastrointestinal system that may increase the risk of certain cancers.

Intestinal lymphomas (cancers that start in immune system cells in the intestines) and other gastrointestinal cancers (including cancers of the small intestine or esophagus) are among the cancer types linked to celiac disease in various studies. People with celiac disease face only a slightly elevated risk of these cancers, and that risk may be lowered to average levels by adhering to a strict gluten-free diet. It’s important to note that having an elevated risk doesn’t mean that you will get cancer, and most people with celiac disease will not develop related cancers.

One of the primary cancers associated with celiac disease is lymphoma. It starts in immune system cells, which is why it’s sometimes linked to celiac disease and some other autoimmune disorders.

In contrast, people with celiac disease appear to have lower odds of developing breast and lung cancer than the general population. The reason for decreased breast and lung cancer cases among celiac disease patients isn’t well established, but it may be due to shared factors within this group that are protective against certain cancers. For example, people with celiac disease tend to have a low body mass index, which may help prevent breast cancer.

What is celiac disease?

Celiac disease is an autoimmune disorder, meaning that the body mistakenly attacks itself with its own defense against disease (the immune system). About one in 100 people worldwide have celiac disease, according to the U.S. National Library of Medicine.

  • In people with celiac disease, the immune system registers gluten (a protein found in certain grains) as a threat.
  • The presence of gluten prompts the immune system to attack healthy tissues in the intestines, resulting in inflammation.
  • This inflammation is considered to be the main driver behind the link between celiac disease and certain cancers.
  • Celiac disease also makes it harder for the body to absorb nutrients, which may be partially responsible for the link, too.

Research suggests that celiac disease is primarily caused by genetic (inherited) factors, although environmental factors may also play a role. Scientists have discovered that nearly all individuals with celiac disease have specific changes (mutations) within certain genes that may alter the normal functioning of the immune system and trigger the development of celiac disease. However, the mutations linked to celiac disease are carried by many who don’t have the condition, so these genetic changes cannot be the only cause.

Gastrointestinal symptoms—such as stomach pain, bloating and food intolerance—are among the most common and well-known signs of celiac disease. Classic celiac disease refers to those who mainly experience these symptoms.

Although digestive symptoms are likely the most well-known signs of celiac disease, research suggests that many patients don’t experience them. The inflammation and nutritional deficiencies associated with celiac disease may cause problems far beyond the digestive system. Those who don’t experience gastrointestinal symptoms and instead have one or more of the following symptoms are said to have nonclassic celiac disease:

  • Iron-deficiency anemia
  • Vitamin deficiencies
  • Osteoporosis (weak bones)
  • Rashes
  • Defects in teeth enamel
  • Tiredness
  • Pain in joints
  • Delayed growth
  • Fertility problems
  • Migraines
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Epilepsy
  • Depression

These non-digestive symptoms are broad and disparate, making it difficult to link them to celiac disease. Some patients experience no symptoms at all (silent celiac disease). As a result, many patients go undiagnosed.

Treating celiac disease requires patients to cut out gluten from their diet and maintain a gluten-free diet throughout life.

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