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No Good Case for Mass Celiac Screening Just Yet
Celiac.com 11/09/2015 - Can mass screening for celiac disease help enough people, and improve enough lives to justify the cost and effort?
While celiac disease fulfills several WHO criteria for mass screening, such as high prevalence, available treatment and difficult clinical detection, it remains unproven that treatment of asymptomatic celiac disease can lower the risk of severe complications and improve quality of life, or that it is cost-effective.
A research team recently set out to review the literature on screening for celiac disease in relation to the current World Health Organization (WHO) criteria for mass screening.
The team included Jonas F Ludvigsson, Timothy R Card, Katri Kaukinen, Julio Bai, Fabiana Zingone, David S Sanders, and Joseph A Murray.
The research team is variously affiliated with the Department of Paediatrics, Örebro University Hospital, Örebro, Sweden, the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, the Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK, the School of Medicine, University of Tampere, Tampere, Finland, the Department of Internal Medicine, Hospital, Tampere University Hospital, Tampere, Finland, the Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland, the Department of Medicine, C Bonorino Udaondo Gastroenterology Hospital, Universidad del Salvador, Buenos Aires, Argentina, the Department of Medicine and Surgery, University of Salerno, Salerno, Italy, the Regional GI and Liver Unit, Royal Hallamshire Hospital, Sheffield, UK, the Department of Medicine, Department of Immunology, Mayo Clinic College of Medicine, Rochester, USA.
The team conducted a PubMed search for all indexed papers on celiac disease screening published from 1900 until mid-2014. For all relevant abstracts the team read the corresponding paper in full.
Their search revealed that current evidence is not sufficient to support mass screening for celiac disease.
However, they do note that this strategy will help most patients with celiac disease, so active case-finding may be appropriate.
They also note that, even though proof of benefit is lacking, screening for celiac disease may be appropriate in high-risk groups.
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Jefferson Adams is a freelance writer living in San Francisco. His poems, essays and photographs have appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate among others.
He is a member of both the National Writers Union, the International Federation of Journalists, and covers San Francisco Health News for Examiner.com.View all articles by Jefferson Adams
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