eng Science and Education Publishing International Journal of Celiac Disease 2334-3486 2023-09-04 11 1 19 22 10.12691/ijcd-11-1-4 IJCD20231114 article Hugh J. Freeman hugfree@shaw.ca 1 Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada A variety of malignancies may complicate the clinical course of adult celiac disease. In a cohort of 154 patients with celiac disease (55 males, 99 females, aged over 30 years) also defined by a single case of cecal cancer, 4 males were observed to have small bowel adenocarcinoma in the duodenum or jejunum during a period of more than 30 years. This far exceeded the cumulative rate for this cancer in the background population (8.6 males per 100,000 over 10 years) indicating that patients with celiac disease, even after treatment with a gluten-free diet, remain at risk for development of small intestinal adenocarcinoma. http://pubs.sciepub.com/ijcd/11/1/4/ijcd-11-1-4.pdf small bowel cancer epithelial carcinogenesis celiac disease gluten-free diet