Prevalence and screening

It is now known that coeliac disease affects far more people than previously thought. A significant body of evidence suggests that the average prevalence across Europe is 1% (table 1). This makes coeliac disease one of the most common chronic autoimmune disorders and is the most common cause of malabsorption in the UK (1).

Coeliac disease affects all ethnic groups, and is common not just in Europe, but also in countries including southern Asia, the Middle East, North West and East Africa and South America (2).

Due to the genetic nature of coeliac disease, the prevalence is increased to 1 in 10 in families where coeliac disease exists (3).

Whether or not screening should be carried out for coeliac disease is still a matter for debate, although case finding of symptomatic patients appears very effective in improving health and preventing complications (4).

Table 1. Screening studies in different populations

References

1. Bingley PJ et al. Avon Longitudinal Study of Parents and Children Study Team. BMJ 2004;328: 322-3

2. Cataldo F, Montalto G. Celiac disease in the developing countries: A new and challenging public health problem. World J Gastroenterol 2007; 13(15): 2153-2159

3. Hogberg L et al. Familial prevalence of coeliac disease: a twenty year follow-up study. Scandinavian Journal of Gastroenterology 2003;38(1):61-5

4. Mearin ML et al. Coeliac disease: is it time for mass screening? Best Practice & Research in Clinical Gastroenterology 2005;19(3):441-52

5. Catassi C et al. Coeliac disease in the year 2000: exploring the iceberg. Lancet 1994;343:200-203

6. Johnston SD et al. Prevalence of coeliac disease in Northern Ireland. Lancet 1997;350:1370

7. Kolho KL et al. Undiagnosed coeliac disease is common in Finnish Adults. Scandinavian Journal of Gastroenterology 1998;33:1280-1283

8. Csizmadia CG et al. An iceberg of childhood coeliac disease in the Netherlands. Lancet 1999;353:813

9. Catassi C et al. Risk of non-Hodgkin lymphoma in celiac disease. JAMA 2002;287:1413-9

10. Riestra S et al. Prevalence of coeliac disease in the general population of northern Spain. Strategies of serologic screening. Scandinavian Journal of Gastroenterology 2000;35:398-402

11. Hovell CJ et al. High prevalence of coeliac disease in a population based study from Western Australia: a case for screening? Medical Journal of Australia 2001;175:247-50

12. Lagerqvist C et al. Screening for adult coeliac disease - which serologic marker(s) to use? Journal of International Medicine 2001;250:241-8

13. Gomez JC et al. Prevalence of celiac disease in Argentina: screening of an adult population in the La Plata area. American Journal of Gastroenterology 2001;96:2700-4

14. Pratesi R et al. Prevalence of coeliac disease: unexplained age-related variation in the same population. Scandinavian Journal of Gastroenterology 2003;38:747-750

15. Fasano A et al. Prevalence of celiac disease in at-risk and non-at-risk groups in the United States: a large multicentre study. Archives of International Medicine 2003;163:286-92 

16. Maki M et al. Prevalence of coeliac disease among children in Finland. New England Journal of Medicine 2003;348:2517-24

17. West J et al. Seroprevalence, correlates and characteristics of undetected coeliac disease in England. Gut 2003;52:960-5

18. Schweizer JJ et al. Coeliac disease in the Netherlands. Scandinavian Journal of Gastroenterology 2004;39:359-64