ity, mortality from malignant neoplasms, non-Hodgkin's lymphoma and digestive system disorders were significantly higher in gluten sensitive patients compared to the Northern Ireland population. CONCLUSION:Patients with coeliac disease or gluten sensitivity had higher mortality rates than the Northern Ireland population. This association persists more than one year after diagnosis in patients testing positive for anti-gliadin antibodies. Breast cancer is significantly reduced in the cohort of patients with gluten sensitivity. INTRODUCTIONCoeliac disease (CD) is an autoimmune disorder characterised by inflammation and villous atrophy of the small intestine, resulting in the malabsorption of vitamins and nutrients. It is caused by an immune response to wheat gluten (gliadin). Ireland is thought to have one of the highest incidences of CD in the world with a prevalence in Northern Ireland of at least 1 person per 122 in the population [1] . Diagnosis is normally confirmed by duodenal biopsy; however, highly sensitive and specific blood tests for CD are available including the transglutaminase antibody test (93% sensitive, > 99% specific) and the endomysial antibody (EMA) test (93% sensitive, > 98% specific) [2] . Another test the anti-gliadin antibody (AGA) test is not as sensitive or specific for CD. It is a measure of the immune response to gliadin and may detect people with gluten sensitivity who don't have clinically detectable CD. Patients testing positive for CD are advised to adhere to a strict gluten free diet for life [3,4] to avoid symptoms such as diarrhoea, anaemia and weight loss associated with this condition.In addition to the significant morbidity that can be associated with this condition, CD is thought to be associated with an increased risk of malignancy and mortality. A recent European multi-centre study reported more than CLINICAL RESEARCH Malignancy and mortality in a population

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Among all 14 500 incident cases of basal cell carcinoma (BCC), 6405 squamous cell carcinomas (SCC) and 1839 melanomas reported to the Northern Ireland Cancer Registry between 1993 and 2002, compared with the general population, risk of new primaries after BCC or SCC was increased by 9 and 57%, respectively. The subsequent risk of cancer, overall, was more than double after melanoma.

Background The restructuring of healthcare systems to cope with the demands of the COVID-19 pandemic has led to a reduction in clinical services such as cancer screening and diagnostics. Methods Data from the four Northern Ireland pathology laboratories were used to assess trends in pathological cancer diagnoses from 1st March to 12th September 2020 overall and by cancer site, sex and age. These trends were compared to the same timeframe from 2017 to 2019. Results Between 1st March and 12th September 2020, there was a 23% reduction in cancer diagnoses compared to the same time period in the preceding 3 years. Although some recovery occurred in August and September 2020, this revealed inequalities across certain patient groups. Pathological diagnoses of lung, prostate and gynaecological malignancies remained well below pre-pandemic levels. Males and younger/middle-aged adults, particularly the 50–59-year-old patient group, also lagged behind other population demographic groups in terms of returning to expected numbers of pathological cancer diagnoses. Conclusions There is a critical need to protect cancer diagnostic services in the ongoing pandemic to facilitate timely investigation of potential cancer cases. Targeted public health campaigns may be needed to reduce emerging inequalities in cancer diagnoses as the COVID-19 pandemic continues.

Objective To evaluate precision and recall rates for the automatic extraction of information from free-text pathology reports. To assess the impact that implementation of pattern-based methods would have on cancer registration completeness. Method Over 300,000 electronic pathology reports were scanned for the extraction of Gleason score, Clark level and Breslow depth, by a number of Perl routines progressively enhanced by a trial-and-error method. An additional test set of 915 reports potentially containing Gleason score was used for evaluation. Results Values for recall and precision of over 98 and 99%, respectively, were easily reached. Potential increase in cancer staging completeness of up to 32% was proved. Conclusions In cancer registration, simple pattern matching applied to free-text documents can be effectively used to improve completeness and accuracy of pathology information.