Mortality in people with coeliac disease: long-term follow-up from a Scottish cohort

Quarpong, Wilhemina; Card, Timothy R.; West, Joe; Solaymani-Dodaran, Masoud; Logan, Richard F.A.; Grainge, Matthew J.

Abstract

Background: Few studies have determined the very long-term mortality risks in adult and childhood-diagnosed coeliac disease.

Objective: We quantified mortality risks in coeliac disease and determined whether age at diagnosis, or time following diagnosis modified these risks.

Methods: Standardised mortality ratios (SMRs) were determined using data from a cohort of 602 coeliac patients assembled between 1979 and 1983 from Lothian, Scotland, and followed up from 1970 until 2016.

Results: All-cause mortality was 43% higher than in the general population. Excess deaths were primarily from haematological malignancies (SMR, 4.77) and external causes (SMR, 2.62) in adult and childhood-diagnosed cases respectively. Mortality risks declined steadily with time in adult-diagnosed cases (SMR, 4.85 in first year compared to 0.97, 25 years post-diagnosis). Beyond 15 years, this group had a significantly reduced risk of any malignancy (SMR, 0.57 [95% CI: 0.33-0.92]). In contrast, for childhood-diagnosed cases an increased risk existed beyond 25 years (SMR, 2.24).

Conclusions: Adult-diagnosed coeliac patients have a temporary increased mortality risk mainly from malignant lymphomas and a decreased risk of any malignancy beyond 15 years post-diagnosis. In contrast, childhood-diagnosed cases are at an increased risk of mortality mainly from external causes, and have long-term mortality risks that requires further investigation.
 

Citation

Quarpong, W., Card, T. R., West, J., Solaymani-Dodaran, M., Logan, R. F., & Grainge, M. J. (2019). Mortality in people with coeliac disease: long-term follow-up from a Scottish cohort. United European Gastroenterology Journal, 7(3), 377-387. https://doi.org/10.1177/2050640618814662

• Journal Article Type: Article
• Acceptance Date: Oct 29, 2018
• Online Publication Date: Nov 18, 2018
• Publication Date: Apr 1, 2019
• Deposit Date: Nov 1, 2018
• Publicly Available Date: Nov 1, 2018
• Journal: United European Gastroenterology Journal
• Print ISSN: 2050-6406
• Electronic ISSN: 2050-6414
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 7
• Issue: 3
• Pages: 377-387
• DOI: https://doi.org/10.1177/2050640618814662
• Keywords: Gastroenterology; Oncology
• Public URL: https://nottingham-repository.worktribe.com/output/1216993
• Publisher URL: https://journals.sagepub.com/doi/abs/10.1177/2050640618814662
• Contract Date: Nov 1, 2018