eng Science and Education Publishing International Journal of Celiac Disease 2334-3486 2021-11-10 9 3 93 95 10.12691/ijcd-9-3-5 IJCD2021935 article Hugh J. Freeman hugfree@shaw.ca 1 Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, British Columbia, Canada Some malignant disorders, including colorectal cancer (CRC), may be reduced in celiac disease. In this study, 154 older adults, including elderly adults over age 60 years, were seen over 30 years. All patients were biopsy-defined and treated with a gluten-free diet. A single elderly female had an early stage colon cancer in the cecum but a persistent iron deficiency anemia led to later detection of biopsy-defined celiac disease and a gluten-free diet mucosal response. This study indicates that colon cancer is rare in biopsy-defined celiac disease. In this study, there were no gastric, pancreatic or hepato-biliary tract cancers seen. Genetic and environmental dietary factors may play a role, however, the rarity of colorectal cancer in other celiac-associated colonic diseases (eg., collagenous or lymphocytic colitis) suggests that an immune-mediated protective effect may occur. http://pubs.sciepub.com/ijcd/9/3/5/ijcd-9-3-5.pdf colorectal cancer celiac disease cancer prevention elderly celiac disease