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The big question is the one of increased risk of cancer in Coeliac Disease. You may be wondering “How long do I have to be on a gluten-free diet to lower my subsequent risk of bowel cancer?” The classic malignancy associated with Coeliac Disease is a lymphoma of the small intestine (its full name is: enteropathy-associated T-cell lymphoma). However, cancers of the small intestine, oesophagus, and pharynx are also associated with Coeliac Disease. The good news is that a strict gluten-free diet does protect against these malignancies. This has been shown in a systematic longitudinal study (Gut, Vol 30, 333-338; 1989). Their results indicate that if you are on a gluten-free diet for five years or more, then the risk of developing cancer is not increased when compared with the general population. For children, put on a gluten-free diet, and staying on their gluten-free diet life-long, the cancer issue is probably irrelevant. However, it is important for them to know about the cancer risk should they decide to abandon their diet. This protective effect (and protection against osteoporosis) remains the strongest argument for total withdrawal of gluten from the diet of patients sensitive to gluten.
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