Celiac.com 08/02/2013 - A great deal of effort goes into determining the best procedures for screening for celiac disease. Ideally it would be great to test everyone, but that is currently too expensive on such a large scale. So, one of the things researchers study is how to get the best results with limited resources.

Photo: WikiMedia Commons--Jawed KarimTo better understand the cost-effectiveness of universal screening for celiac disease versus screening only patients who are at risk for or showing symptoms of celiac disease, a team of researchers looked specifically at the high risk, and associated costs, of non-traumatic hip and vertebral fractures if celiac disease is untreated or undiagnosed. Their results appear in Clinical Gastroenterology and Hepatology.

The team found that the current standard practice of screening adolescents who are either symptomatic or at high-risk for celiac disease proves to be more cost-effective than universal screening.

They also found that screening helps to prevent decreased bone mineral density, which can affect up to 70 percent of untreated celiac patients, and often leads to osteoporosis and non-traumatic hip and vertebral fractures.

Overall, blanket screening and selective screening both had similar lifetime costs and quality of life ratings, but screening only those at risk or with actual symptoms proved to be more cost effective in preventing bone loss and fractures among patients with undiagnosed or subclinical celiac disease.

They noted that additional analyses looking at risk and cost of other potential consequences of undiagnosed and untreated celiac disease, such as anemia, infertility and malignancy, might change the cost-effectiveness balance more in favor of universal screening for celiac disease.

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