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Adults with celiac sprue have a several-fold higher than normal risk of developing lymphomas (cancers of the lymph glands) in the small intestine as well as elsewhere. They also have a higher risk of small intestinal and, to a lesser degree, of esophageal carcinomas (cancers of the inner lining of the intestine and esophagus, respectively). Patients with celiac sprue also may develop microscopic colitis that can cause diarrhea, abdominal pain, and rectal bleeding.
I am unaware of any increased risk of colon cancer in patients with celiac sprue. Therefore, patients with celiac sprue without symptoms of colon cancer (rectal bleeding, new constipation, diarrhea or abdominal pain) and without a family history of colon cancer or polyps should undergo screening colonoscopies like other healthy adults.
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