Celiac disease is an autoimmune condition triggered by eating the protein gluten. Gluten is found in grains like:

  • wheat
  • “It’s called rye.”
  • There is a vegetable called barley.

It’s estimated that about 2 million people in the United States have celiac disease, but many of these people have not been diagnosed yet.

When people with celiac disease eat gluten, their immune system responds by attacking their small intestine. This immune reaction damages the finger-like projections called villi along the small intestine. Damage to villi interferes with the body’s ability to absorb nutrients.

Researchers think that people with celiac disease are at an elevated risk of developing some types of cancer, like non-Hodgkin’s lymphoma (NHL).

They are at a higher risk of developing a rare but aggressive type of NHL called enteropathy-associated T-cell lymphoma.

We know a lot about the link between NHL and celiac disease.

The majority of people with celiac disease have an excellent outlook if they adopt a gluten-free diet. However, researchers think that people with celiac disease are at an increased risk of developing some types of cancer, including NHL.

The majority of people with the disease do not develop cancer.

Celiac disease and cancer

According to a 2021 literature review, many studies have examined the link between celiac disease and cancer.

Some studies found that people with the disease have a higher risk of developing cancer than the general population, while other studies found no difference.

A large 2022 study in Sweden found that a group of 47,241 people with celiac disease developed cancer slightly more often than people without celiac disease.

The researchers reported that in a year, around 6.5 out of every 1,000 people with the disease developed cancer, compared with 5.7 out of every 1,000 people in the general population.

The risk of cancer was only increased in the first year after a diagnosis of a disease, and only in people over the age of 40. People with a diagnosis of celiac disease after the age of 60 were at the highest risk.

Celiac disease and non-Hodgkin’s lymphoma

Early studies estimated people with celiac disease were 100 times more likely to develop lymphoma, but this number is now estimated to be much lower. Most studies now report a 3 to 12 times higher risk of all types of NHL and a 16 to 40 times higher risk of gut lymphomas.

Almost all studies in the literature review have found that the risk of dying from lymphoma is higher in people with celiac disease.

In a large 2020 study from Finland, researchers found that people with celiac disease had a 2.36 times higher chance of dying from lymphoma than the general population.

Celiac disease and enteropathy-associated T-cell lymphoma

A small number of people with celiac disease, about 1 to 2 percent, develop refractory celiac disease.

Refractory celiac disease is when celiac disease does not respond to at least 12 months of treatment with a gluten-free diet. It’s associated with a rare form of NHL called enteropathy-associated T-cell lymphoma (EATL).

EATL is an aggressive type of lymphoma with a poor prognosis, and it develops in the intestines. The vast majority of cases of EATL develop from refractory celiac disease.

“Inflammation occurs in the white blood cell called the lymphocytes. Your body has cells in it’s lining.”

According to the American Cancer Society, it’s thought that the overactivation of the immune system in autoimmune diseases like celiac disease might make lymphocytes grow and divide more often than normal, increasing their risk of becoming cancerous.

In a 2016 study, researchers examined the risk of cancer in first degree relatives of people with celiac disease. They found that first degree relatives were not at an elevated risk of cancer. This suggests that shared genes likely do not explain the risk of lymphoma in people with celiac disease.

The presence of certain genes may play a role in the development of EATL in people with refractory celiac disease. In a 2022 study, researchers found strong evidence that mutations in the JAK1-STAT3 pathway are the main drivers of lymphocytic changes.

It is important to avoid eating wheat if you have the disease. Even small amounts of the wheat-based food can cause symptoms.

In the 2022 Swedish study, researchers found that the risk of celiac disease was only highest in the first year after diagnosis. The researchers note that this may be because switching to a gluten-free diet could help reduce the risk.

In a 2022 review, researchers found evidence that in people with celiac disease, not following a gluten-free diet increases the risk of developing cancer. However, more research is needed to fully understand the link.

The other risk factors for developing NHL are not yours to control.

According to the American Cancer Society, some studies suggest that having overweight or obesity increases your risk of NHL. Eating a balanced, nutritious diet and exercising regularly may help reduce your chances of developing lymphoma.

NHL can cause many different symptoms.

  • Where the cancer starts in your body.
  • How advanced is it?
  • Which type you have?

You may not have any symptoms until the cancer is large.

Some of the most common signs and symptoms include:

NHL symptoms can also include “B symptoms,” which play an important role in staging lymphoma. These are:

Some of the symptoms of NHL, like fatigue and weight loss, can also be signs of celiac disease. The main symptoms of EATL are gut problems, which can mimic diseases like celiac disease.

It is important to visit your doctor when you have new symptoms. Your doctor can help determine the cause.

“People with the disease are more likely to develop cancer like NHL than the general population. Most people with the disease don’t develop cancer.”

You can minimize your chances of developing celiac complications by sticking to a gluten-free diet. The outlook for most people with celiac disease is excellent when they avoid gluten.

A small number of people with the disease still have symptoms even after they stop eating wheat. If you fall into this category, your doctor can help you develop a plan.