Q. What is the link between celiac disease and cancer?
A. There is an increased risk of developing lymphoma of the digestive tract and the bloodstream in those who have celiac disease and go undiagnosed and do not eat a gluten-free diet, or in those who have celiac disease, and who do not stay on the diet. If the initial biopsy used to make the diagnosis was a Marsh III or worse (Marsh I means no architectural change to the villi; Marsh IV means complete destruction of the villi), then the risk is greater than the rest of the population that does not have celiac disease. There is a very slightly increased risk in developing other solid tumors of the gut, such as colon cancer or esophageal cancer, if one does not adhere to the gluten-free diet. If, at the time of diagnosis, the biopsy is Marsh III or worse, you should also get imaging of the rest of the small intestine. The best way for this is still the barium swallow small bowel follow-through test.
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