We assessed whether celiac disease-associated mortality is increased in Finland among patients diagnosed in the 21st century, given recent improvements in diagnostic and treatment facilities.
Biopsy-proven patients with celiac disease (Marsh III) and dermatitis herpetiformis aged 20–79 years (median 50 years) diagnosed 2005–2014 (n = 12,803) were identified from the national dietary grant registry. Dates and causes of death were obtained from Statistics Finland. Overall mortality and causes of death were compared with reference individuals (n = 38,384) matched for age, sex, and area of residence (at the time of celiac disease diagnosis) selected from the Population Information System.
During a mean follow-up of 7.7 years (SD ±3.0 years), 884 (6.9%) and 2,613 (6.8%) deaths occurred among the celiac cohort and reference group, respectively. Overall mortality (hazard ratio [HR] 1.01, 95% confidence intervals [CIs] 0.94–1.09), mortality from all malignancies (HR 1.11, 95% CI 0.96–1.27), gastrointestinal tract malignancies (HR 1.21, 95% CI 0.56–1.71), or cardiovascular diseases (HR 0.91, 95% CI 0.77–1.07) were not increased among patients with celiac disease. Overall, mortality from lymphoproliferative diseases (HR 2.36, 95% CI 1.65–3.39) and nonmalignant digestive diseases (HR 2.19, 95% CI 1.40–3.43) was increased, but HRs decreased after the exclusion of the first 2 years of follow-up (HR 1.71, 95% CI 1.10–2.66 and HR 1.75, 95% CI 1.01–3.05, respectively).
The overall mortality in adult celiac disease diagnosed 2005–2014 was not increased. Mortality from lymphoproliferative diseases was increased but lower than previously reported.