Jonas F Ludvigsson1, Timothy R Card2, Katri Kaukinen3, Julio Bai4, Fabiana Zingone5, David S Sanders6, Joseph A Murray7. 1. Department of Paediatrics, Örebro University Hospital, Örebro, Sweden ; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 2. Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK. 3. School of Medicine, University of Tampere, Tampere, Finland ; Department of Internal Medicine, Hospital, Tampere University Hospital, Tampere, Finland ; Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland. 4. Department of Medicine, C Bonorino Udaondo Gastroenterology Hospital, Universidad del Salvador, Buenos Aires, Argentina. 5. Department of Medicine and Surgery, University of Salerno, Salerno, Italy. 6. Regional GI and Liver Unit, Royal Hallamshire Hospital, Sheffield, UK. 7. Department of Medicine, Department of Immunology, Mayo Clinic College of Medicine, Rochester, USA.
Abstract
BACKGROUND: Celiac disease (CD) occurs in approximately 1% of the Western population. It is a lifelong disorder that is associated with impaired quality of life (QOL) and an excessive risk of comorbidity and death. OBJECTIVES: To review the literature on screening for CD in relation to the current World Health Organization (WHO) criteria for mass screening. METHODS: We performed a PubMed search to identify indexed papers on CD screening with a publication date from 1900 until 1 June 2014. When we deemed an abstract relevant, we read the corresponding paper in detail. RESULTS: CD fulfills several WHO criteria for mass screening (high prevalence, available treatment and difficult clinical detection), but it has not yet been established that treatment of asymptomatic CD may reduce the excessive risk of severe complications, leading to higher QOL nor that it is cost-effective. CONCLUSIONS: Current evidence is not sufficient to support mass screening for CD, but active case-finding may be appropriate, as we recognize that most patients with CD will still be missed by this strategy. Although proof of benefit is still lacking, screening for CD may be appropriate in high-risk groups.
BACKGROUND:Celiac disease (CD) occurs in approximately 1% of the Western population. It is a lifelong disorder that is associated with impaired quality of life (QOL) and an excessive risk of comorbidity and death. OBJECTIVES: To review the literature on screening for CD in relation to the current World Health Organization (WHO) criteria for mass screening. METHODS: We performed a PubMed search to identify indexed papers on CD screening with a publication date from 1900 until 1 June 2014. When we deemed an abstract relevant, we read the corresponding paper in detail. RESULTS:CD fulfills several WHO criteria for mass screening (high prevalence, available treatment and difficult clinical detection), but it has not yet been established that treatment of asymptomatic CD may reduce the excessive risk of severe complications, leading to higher QOL nor that it is cost-effective. CONCLUSIONS: Current evidence is not sufficient to support mass screening for CD, but active case-finding may be appropriate, as we recognize that most patients with CD will still be missed by this strategy. Although proof of benefit is still lacking, screening for CD may be appropriate in high-risk groups.
Entities:
Keywords:
Celiac disease; World Health Organization; gluten; gluten-free diet; prevention; quality of life; review; risk; screening
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