Small Bowel Adenocarcinoma

Small bowel (SB) cancers also occur with increased frequency in patients with celiac disease. The true risk of SB adenocarcinoma is unknown, but the older literature suggested relative risks ranging to over 82. A more recently published study with a strong study design suggests that the risk of SB adenocarcinoma is increased approximately ten-fold in celiac disease [64]. Other recent studies report the risk of small bowel adenocarcinoma ranging from no increased risk [65] to a standardized mortality rate of 34 [69]. It is generally thought that there is no evidence for a polyp-cancer sequence in celiac disease-associated small bowel adenocarcinoma, but one report of seven cases of SB neoplasia showed three adenomas and four adenocarcinomas, with one being adjacent to a jejunal tubulovillous adenoma [70].

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