European multicentre project on coeliac disease and non-hodgkin lymphoma

Información del proyecto

Identificador del acuerdo de subvención: BMH4983091

Proyecto cerrado

Fecha de inicio 1 Mayo 1998

Fecha de finalización 30 Junio 2002

Financiado con arreglo a

• Specific research, technological development and demonstration programme in the field of biomedicine and health, 1994-1998

Coste total

Sin datos

Aportación de la UE

Sin datos

Coordinado por

Academisch Ziekenhuis Leiden
Netherlands

Objetivo

Objectives
To evaluate whether in Europe untreated coeliac disease is a primary risk factor to develop cancer, in particular non-Hodgkin lymphoma at any primary site, and to quantify the relative risk.
To determine whether patients with coeliac disease who develop non-Hodgkin lymphoma are genetically different from those who do not.

Coeliac disease (CD) is a permanent intolerance for proteins of grains (wheat, rye, barley and possibly oats) called gluten, characterized by villous atrophy of the small intestine. The disease is treated with a gluten-free diet. The incidence of diagnosed CD in Europe is about 1: 2000 live births. Typical cases manifest with chronic diarrhoea, weight loss and abdominal distension. However, the clinical spectrum of CDis highly heterogeneous and many CD cases present with extra intestinal complaints, such as anaemia, short stature, pubertal delay, osteoporosis or neurological disorders. Sometimes CD is clinically silent. The widespread use of CD screening tests (determination in serum of IgA antigliadin and antiendomysium antibodies) has shown that, in most European countries, the number of CD cases which remain undiagnosed anduntreated is, much higher than the number of patients who are correctly diagnosed on clinical ground. A recent Italian multicentre survey on 17,201apparently healthy students showed a prevalence of CD of 1 in 184 subjects, with a ratio of 1:7 recognized versus unrecognised CD cases. These results indicate that in Europe CDis one of the most common lifelong disorders.

Persons with CD have malignancies, especially of the gastrointestinal tract, at a significantly higher frequency than the general population: 8.1-13.3% of the patients develop cancer. In CD there is a 43-fold relative risk (RR) for non-Hodgkin small bowel Iymphoma, a 12-fold RR for oesophagus cancer and a10-fold RR for cancer of the mouth and pharynx. A prolonged treatment with agluten-free diet seems to play a protective role against cancer in these patients. Recent studies suggest that patients with untreated CD are also at high risk of developing non-Hodgkin Iymphoma (NHL) of any primary site. Patients affected by dermatitis herpetiformis, which is considered one of the many clinical forms of CD, are at 5-10 fold risk of developing NHL. While primary intestinal Iymphoma is a rare condition, NHL is one of the most common neoplastic disorders in Europe. The purpose of this study is to evaluate whether in Europe untreated CD is a primary risk factor to developed NHL at any primary site and to quantify the relative risk. The hypothesis is that in Europe untreated (unrecognised, Subclinical, asymptomatic, neglected) CD is responsible for a heavy burden of preventable malignancies in the general European population. Plan of investigation: Multicentre, European, prospective, case-control study.

Cases: persons with NHL at onset identified in defined areas. Controls: patients sex and age-matched to the cases, seen at hospitals for disorders not related to CD. The existence of untreated CD will be investigated in cases and in controls by means of clinical, serological, histological and HLA studies. The hypothesis will be indirectly tested by comparing the prevalence of CD in subjects with NHL and in the controls.

Relevance: This study represents a significant step forward on the epidemiological European research to determinate abnormalities which can predispose to cancer. If the prevalence for NHL is significantly increased in untreated CD. The identification and treatment of missed cases of CD should become important in the prevention of cancer in Europe and in the improvement of the health of the European population.

Ámbito científico (EuroSciVoc)

• ciencias naturales › ciencias biológicas › bioquímica › biomoléculas › proteínas
• ciencias médicas y de la salud › ciencias de la salud › nutrición
• ciencias médicas y de la salud › medicina clínica › oncología
• ciencias médicas y de la salud › medicina básica › neurología
• ciencias agrícolas › agricultura, silvicultura y pesca › agricultura › granos y semillas oleoaginosas › cereales

Programa(s)

• FP4-BIOMED 2 - Specific research, technological development and demonstration programme in the field of biomedicine and health, 1994-1998

Tema(s)

• 4.1.5 - Predisposition, early diagnosis and treatment

Convocatoria de propuestas

Datos no disponibles

Régimen de financiación

CON - Coordination of research actions

Coordinador

Academisch Ziekenhuis Leiden

• Aportación de la UE: Sin datos
• Dirección: 2,Albinusdreef ; 2333 ZA Leiden ; Países Bajos
• Coste total: Sin datos