{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T15:35:51Z","timestamp":1770824151901,"version":"3.50.1"},"reference-count":38,"publisher":"BMJ","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1976,8]]},"abstract":"<jats:p>Two hundred and two patients with coeliac disease or idiopathic steatorrhoea previously reported from this unit have been reviewed after a further 10 years of follow-up. Of 20 more deaths, 10 were due to malignancy. A separate study was made of all patients with histologically confirmed coeliac disease seen to the end of 1972 and followed up to the end of 1974. Twenty-one of the 43 deaths in this series were due to malignant tumours, of which 13 were reticulum cell sarcomas. There was no evidence that patients showing sub-optimal clinical response to gluten withdrawal or persisting falt jejunal biopsies were more prone to die of cancer. A gluten-free diet did not appear to be effective in preventing malignant complications, but a longer follow-up of patients will be necessary to provide a final answer to this question.<\/jats:p>","DOI":"10.1136\/gut.17.8.612","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"612-619","source":"Crossref","is-referenced-by-count":192,"title":["Coeliac disease, gluten-free diet, and malignancy."],"prefix":"10.1136","volume":"17","author":[{"given":"G K","family":"Holmes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P L","family":"Stokes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T M","family":"Sorahan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Prior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J A","family":"Waterhouse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W T","family":"Cooke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1976,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/BF02233180","article-title":"Steatorrhea and malignant lymphoma: the relationship of malignant tumors of lymphoid tissue and celiac disease","volume":"12","author":"Austad, W.I.; Cornes, J.S.; Gough, K.R.; McCarthy, C.F.; Read, A.E.","year":"1967","unstructured":"Austad, W. I., Cornes, J. S., Gough, K. R., McCarthy, C. F., and Read, A. E. (1967). Steatorrhea and malignant lymphoma: the relationship of malignant tumors of lymphoid tissue and celiac disease. American Journal of Digestive Diseases, 12, 475-490.","journal-title":"American Journal of Digestive Diseases"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1016\/S0140-6736(64)91555-7","article-title":"Coeliac disease and malignant change","volume":"1","author":"Barrett, G.M.","year":"1964","unstructured":"Barrett, G. M. (1964). Coeliac disease and malignant change. (Letter.) Lancet, 1, 723.","journal-title":"(Letter.) Lancet"},{"key":"ref_3","first-page":"665","article-title":"Coeliac disease and malignancy","volume":"42","author":"Barry, R.E.; Read, A.E.","year":"1973","unstructured":"Barry, R. E., and Read, A. E. (1973). Coeliac disease and malignancy. Quarterly Journal of Medicine, 42, 665-675.","journal-title":"Quarterly Journal of Medicine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S0300-5089(21)00351-5","article-title":"The clinical presentation","volume":"3","author":"Barry, R.E.; Baker, P.; Read, A.E.","year":"1973","unstructured":"Barry, R. E., Baker, P., and Read, A. E. (1973). The clinical presentation. Clinics in Gastroenterology, 3, 55-69.","journal-title":"Clinics in Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1136\/bmj.2.5250.496","article-title":"Case of mesenteric reticulosarcoma associated with gluten-sensitive steatorrhoea","volume":"2","author":"Best, C.N.; Cook, P.B.","year":"1961","unstructured":"Best, C. N., and Cook, P. B. (1961). Case of mesenteric reticulosarcoma associated with gluten-sensitive steatorrhoea. British Medical Journal, 2, 496-498.","journal-title":"British Medical Journal"},{"key":"ref_6","first-page":"130","article-title":"Symptomatic sprue: a study of six verified cases..4cta Medica","volume":"137","author":"Bjerkelund, C.J.","year":"1950","unstructured":"Bjerkelund, C. J. (1950). Symptomatic sprue: a study of six verified cases..4cta Medica Scandinavica, 137, 130-149.","journal-title":"Scandinavica"},{"key":"ref_7","first-page":"180184","article-title":"Neoplasia and the coeliac syndrome in adults","volume":"1","author":"Brunt, P.W.; Sircus, W.; MacLean, N.","year":"1969","unstructured":"Brunt, P. W., Sircus, W., and MacLean, N. (1969). Neoplasia and the coeliac syndrome in adults. Lancet, 1, 180184.","journal-title":"Lancet"},{"key":"ref_8","article-title":"Tables for comparative composite cohort analysis","volume":"13","author":"Case, R.A.M.; Pearson, J.T.","year":"1957","unstructured":"Case, R. A. M., and Pearson, J. T. (1957). Tables for comparative composite cohort analysis. In Cancer Statistics for England and Wales, 1901-1955. Edited by A. M. McKenzie. (General Register Office, Studies on Medical Population Subjects, No. 13.) H.M.S.O., London.","journal-title":"Cancer Statistics for England and Wales; (General Register Office, Studies on Medical Population Subjects"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0300-5089(21)00348-5","article-title":"Introduction and definition of coeliac disease","volume":"3","author":"Cooke, W.T.; Asquith, P.","year":"1974","unstructured":"Cooke, W. T. and Asquith, P. (1974). Introduction and definition of coeliac disease. Clinics in Gastroenterology, 3, 3-10.","journal-title":"Clinics in Gastroenterology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1136\/gut.10.2.108","article-title":"Malignancy and adult coeliac disease","volume":"10","author":"Cooke, W.T.; Thompson, H.; Williams, J.A.","year":"1969","unstructured":"Cooke, W. T., Thompson, H., and Williams, J. A. (1969). Malignancy and adult coeliac disease. Gut, 10, 108-111.","journal-title":"Gut"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1136\/bmj.2.5422.1435","article-title":"Malignancy and the small-intestinal mucosa","volume":"2","author":"Creamer, B.","year":"1964","unstructured":"Creamer, B. (1964). Malignancy and the small-intestinal mucosa. British MedicLl Journal, 2, 1435-1436.","journal-title":"British MedicLl Journal"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S0065-230X(08)60169-4","article-title":"Aspects of the EB virus","volume":"13","author":"Epstein, M.A.","year":"1970","unstructured":"Epstein, M. A. (1970). Aspects of the EB virus. Advances in Cancer Research, 13, 383-411.","journal-title":"Advances in Cancer Research"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1136\/bmj.1.3972.375","article-title":"The clinical and biochemical syndrome in lymphadenoma and allied diseases involving mesenteric lymph nodes","volume":"1","author":"Fairley, N.H.; Mackie, F.P.","year":"1937","unstructured":"Fairley, N. H., and Mackie, F. P. (1937). The clinical and biochemical syndrome in lymphadenoma and allied diseases involving mesenteric lymph nodes. British Medical Journal, 1, 375-380.","journal-title":"British Medical Journal"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1002\/1097-0142(196510)18:10<1278::AID-CNCR2820181010>3.0.CO;2-E","article-title":"Disacchariduria in malignant disease","volume":"18","author":"Fischer, R.A.; Rosoff, B.M.; Altsuler, J.H.; Thayer, Jr., W.R.; Spiro, H.M.","year":"1965","unstructured":"Fischer, R. A., Rosoff; B. M., Altsuler, J. H., Thayer, W. R., Jr., and Spiro, H. M. (1965). Disacchariduria in malignant disease. Cancer, 18, 1278-1284.","journal-title":"Cancer"},{"key":"ref_15","first-page":"481","article-title":"The effect of a wheat-gluten-free diet in adult idiopathic steatorrhoea","volume":"26","author":"French, J.M.; Hawkins, C.F.; Smith, N.","year":"1957","unstructured":"French, J. M., Hawkins, C. F., and Smith, N. (1957). The effect of a wheat-gluten-free diet in adult idiopathic steatorrhoea. Quarterly Journal of Medicine, 26, 481-499.","journal-title":"Quarterly Journal of Medicine"},{"key":"ref_16","article-title":"Steatorrhoea","author":"Friedlander, P.H.; Gorvy, V.","year":"1955","unstructured":"Friedlander, P. H., and Gorvy, V. (1955). Steatorrhoea."},{"key":"ref_17","first-page":"809","article-title":"British Medical","volume":"2","unstructured":"British Medical Journal, 2, 809-812.","journal-title":"Journal"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1002\/1097-0142(197203)29:3<645::AID-CNCR2820290318>3.0.CO;2-4","article-title":"Lymphosarcoma of the small intestine: a clinicopathologic study","volume":"29","author":"Fu, Y.S.; Perzin, K.H.","year":"1972","unstructured":"Fu, Y. S., and Perzin, K. H. (1972). Lymphosarcoma of the small intestine: a clinicopathologic study. Cancer, 29, 645-659.","journal-title":"Cancer"},{"key":"ref_19","author":"Gilat, T.; Fischel, B.; Danon, J.; Loewenthal, M.","year":"1973","unstructured":"Gilat, T., Fischel, B., Danon, J., and Loewenthal, M. (1973)."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1136\/bmj.2.5424.1592","article-title":"Malignancy and the small intestinal mucosa","volume":"2","author":"Girdwood, R.H.","year":"1964","unstructured":"Girdwood, R. H. (1964). Malignancy and the small intestinal mucosa. (Letter.) British Medical Journal, 2, 1592.","journal-title":"(Letter.) British Medical Journal"},{"key":"ref_21","first-page":"892","article-title":"The small intestine and diarrhea","volume":"36","author":"Golden, R.","year":"1936","unstructured":"Golden, R. (1936). The small intestine and diarrhea. American Journal of Roentgenology, 36, 892-901.","journal-title":"American Journal of Roentgenology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1136\/gut.3.3.232","article-title":"Intestinal reticulosis as a complication of idiopathic steatorrhoea","volume":"3","author":"Gough, K.R.; Read, A.E.; Naish, J.M.","year":"1962","unstructured":"Gough, K. R., Read, A. E., and Naish, J. M. (1962). Intestinal reticulosis as a complication of idiopathic steatorrhoea. Gut, 3, 232-239.","journal-title":"Gut"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/0002-9343(67)90071-X","article-title":"Malignancy in adult coeliac disease and idiopathic steatorrhoea","volume":"42","year":"1967","unstructured":"Harris, 0. D., Cooke, W. T., Thompson, H., and Waterhouse, J. A. H. (1967). Malignancy in adult coeliac disease and idiopathic steatorrhoea. American Journ&l of Medicine, 42, 899-912.","journal-title":"American Journ&l of Medicine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/0002-9343(47)90075-2","article-title":"Potassium deficiency in a case of lymphosarcoma with the sprue syndrome","volume":"2","author":"Harrison, H.E.; Harrison, H.C.; Tompsett, R.R.; Barr, D.P.","year":"1947","unstructured":"Harrison, H. E., Harrison, H. C., Tompsett, R. R., and Barr, D. P. (1947). Potassium deficiency in a case of lymphosarcoma with the sprue syndrome. American Journal of Medicine, 2, 131-143.","journal-title":"American Journal of Medicine"},{"key":"ref_25","first-page":"278","article-title":"Cellular infiltrate of jejunal biopsies in adult coeliac disease in relation to gluten withdrawal","volume":"15","author":"Holmes, G.K.T.; Asquith, P.; Stokes, P.L.; Cooke, W.T.","year":"1973","unstructured":"Holmes, G. K. T., Asquith, P., Stokes, P. L., and Cooke, W. T. (1973). Cellular infiltrate of jejunal biopsies in adult coeliac disease in relation to gluten withdrawal. Gut, 15, 278-283.","journal-title":"Gut"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/S0065-2776(08)60285-0","article-title":"Immunological aspects of Burkitt's lymphoma","volume":"14","author":"Klein, G.","year":"1971","unstructured":"Klein, G. (1971). Immunological aspects of Burkitt's lymphoma. Advances in Immunology, 14, 187-250.","journal-title":"Advances in Immunology"},{"key":"ref_27","first-page":"359","article-title":"Intestinal malignant lymphoma and cerebellar cortical degeneration complicating idiopathic steatorrhoea: report of a case with a review of the literature","volume":"115","author":"Missen, G.A.K.","year":"1966","unstructured":"Missen, G. A. K. (1966). Intestinal malignant lymphoma and cerebellar cortical degeneration complicating idiopathic steatorrhoea: report of a case with a review of the literature. Guy's Hospital Reports, 115, 359-385.","journal-title":"Guy's Hospital Reports"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1159\/000199781","volume":"79","author":"Oehler, V.","year":"1953","unstructured":"Oehler, V. (1953). Sprue. Gastroenwerologi7, 79, 257-282.","journal-title":"Sprue. Gastroenwerologi7"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1007\/BF01070840","article-title":"Adenocarcinoma of the jejunum associated with nontropical sprue","volume":"20","author":"Petreshock, E.P.; Pessah, M.; Menachemi, E.","year":"1975","unstructured":"Petreshock, E. P., Pessah, M., and Menachemi, E. (1975). Adenocarcinoma of the jejunum associated with nontropical sprue. American Journal of Digestive Diseases, 20, 796-802.","journal-title":"American Journal of Digestive Diseases"},{"key":"ref_30","article-title":"Personal communication","author":"Read, A.E.","year":"1976","unstructured":"Read, A. E. (1976). Personal communication."},{"key":"ref_31","article-title":"Symptomatic sprue","author":"Salvesen, H.A.; Kobro, M.","year":"1939","unstructured":"Salvesen, H. A., and Kobro, M. (1939). Symptomatic sprue."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"433","DOI":"10.7326\/0003-4819-55-3-433","article-title":"Observations on secondary malabsorption syndromes of intestinal origin","volume":"55","author":"Scudamore, H.H.","year":"1961","unstructured":"Scudamore, H. H. (1961). Observations on secondary malabsorption syndromes of intestinal origin. Annals of Internal Medicine, 55, 433-447.","journal-title":"Annals of Internal Medicine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/0002-9343(53)90155-7","article-title":"The sprue syndrome secondary to lymphoma of the small bowel","volume":"15","author":"Sleisenger, M.H.; Almy, T.P.; Barr, D.P.","year":"1953","unstructured":"Sleisenger, M. H., Almy, T. P., and Barr, D. P. (1953). The sprue syndrome secondary to lymphoma of the small bowel. American Journal of Medicine, 15, 666-674.","journal-title":"American Journal of Medicine"},{"key":"ref_34","first-page":"167","article-title":"Reticulosis of the small bowel as a late complication of idiopathic steatorrhoea","volume":"56","author":"Spracklen, F.","year":"1963","unstructured":"Spracklen, F. (1963). Reticulosis of the small bowel as a late complication of idiopathic steatorrhoea. Proceedings of the Roval Society of Medicine, 56, 167-168.","journal-title":"Proceedings of the Roval Society of Medicine"},{"key":"ref_35","article-title":"Familial aspects of coeliac disease","author":"Stokes, P.L.; Ferguson, R.; Holmes, G.K.T.; Cooke, W.T.","year":"1976","unstructured":"Stokes, P. L., Ferguson, R., Holmes, G. K T., and Cooke, W. T. (1976). Familial aspects of coeliac disease. Quarterly Journal of Medicine. (In press).","journal-title":"Quarterly Journal of Medicine"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0016-5085(19)35795-6","article-title":"The sprue syndrome associated with intra-abdominal lymphoblastoma","volume":"33","author":"Upshaw, Jr., C.B.; M, Pollard H.","year":"1957","unstructured":"Upshaw, C. B., Jr., and Pollard H. M. (1957). The sprue syndrome associated with intra-abdominal lymphoblastoma. Gastroenterology, 33, 104-112.","journal-title":"Gastroenterology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/S0016-5085(19)34345-8","article-title":"Carcinogen-detoxifying mechanisms in the gastrointestinal tract","volume":"51","author":"Wattenberg, L.W.","year":"1966","unstructured":"Wattenberg, L. W. (1966). Carcinogen-detoxifying mechanisms in the gastrointestinal tract. Gastroenterology, 51, 932-935.","journal-title":"Gastroenterology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/S0016-5085(74)80034-X","article-title":"Latent celiac sprue","volume":"66","author":"Weinstein, W.M.","year":"1974","unstructured":"Weinstein, W. M. (1974). Latent celiac sprue. Gastroenterology, 66, 489-493.","journal-title":"Gastroenterology"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.17.8.612","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T14:11:43Z","timestamp":1765635103000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.17.8.612"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1976,8]]},"references-count":38,"journal-issue":{"issue":"8","published-online":{"date-parts":[[1976,8,1]]},"published-print":{"date-parts":[[1976,8]]}},"alternative-id":["10.1136\/gut.17.8.612"],"URL":"https:\/\/doi.org\/10.1136\/gut.17.8.612","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1976,8]]}}}