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Testing for celiac disease (CD) shows benefits for symptomatic individuals. However, outcomes for asymptomatic or adult-diagnosed patients with silent CD require further investigation due to unclear long-term results and compliance issues.

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Area of Science:

  • Gastroenterology
  • Public Health
  • Diagnostic Testing

Background:

  • Celiac disease (CD) is often asymptomatic, with up to two-thirds of cases undiagnosed.
  • Identifying asymptomatic individuals is crucial for proactive health management.

Purpose of the Study:

  • To systematically review the consequences of celiac disease testing across different populations.
  • To evaluate outcomes in symptomatic, asymptomatic at-risk, and general populations.

Main Methods:

  • Conducted a comprehensive literature search across multiple databases (MEDLINE, EMBASE, etc.) up to December 2003.
  • Included study designs such as before-after studies, case control, and retrospective cohorts.
  • Assessed the strength and quality of evidence, noting weaker evidence for before-after studies.

Main Results:

  • Testing for celiac disease in symptomatic individuals positively impacts patient-relevant outcomes.
  • Evidence regarding consequences for silent CD or low-grade lesions is less clear.
  • Compliance with diagnosis and management is suboptimal, particularly for adults diagnosed later in life.

Conclusions:

  • Celiac disease testing benefits symptomatic patients, but long-term outcomes for silent CD require more research.
  • Further high-quality studies are needed to clarify the impact of testing in asymptomatic populations.
  • Adherence to treatment in diagnosed individuals, especially adults, remains a concern.