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Screening for coeliac disease in children
Laura Kivelä1,2, Kalle Kurppa1,3
1Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
Insights
Screening children and adolescents for coeliac disease (an autoimmune disorder) may improve diagnosis, especially in at-risk groups. However, widespread population screening is not yet recommended due to ongoing research needs.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Public Health
Background:
- Coeliac disease is a prevalent gastrointestinal condition in children, often underdiagnosed.
- Untreated coeliac disease can lead to severe long-term health complications.
- Incidence and diagnosis rates have risen significantly in recent decades.
Purpose of the Study:
- To review current concepts regarding coeliac disease screening in pediatric and adolescent populations.
- To evaluate the effectiveness and recommendations for coeliac disease screening strategies.
Main Methods:
- A non-systematic literature review was performed.
- Included studies published from the year 2000 onwards focusing on coeliac disease screening.
Main Results:
- Screening at-risk groups or the general population could enhance diagnostic yield but remains controversial.
- Screening specific high-risk pediatric groups shows potential benefit.
- Untargeted mass screening is not currently advised.
Conclusions:
- Moderate evidence supports screening specific at-risk groups for coeliac disease in children.
- Further research is necessary to validate benefits before recommending large-scale population screening.
- The balance between early diagnosis benefits and lifelong dietary adherence challenges, particularly for asymptomatic individuals, requires further clarification.
Aim:
Coeliac disease is a common but markedly under-diagnosed condition, which may lead to serious long-term complications if untreated. Both the diagnostic yield and true incidence have significantly increased during the last few decades and it is now one of the most common chronic gastrointestinal conditions in children. The aim of this review was to summarise the current concepts on screening for coeliac disease in children and adolescents.
Method:
We conducted a non-systematic literature review of papers published about coeliac disease screening since the year 2000.
Results:
Our review showed that the diagnostic yield could be significantly improved by screening for at-risk groups, or even the whole population, but these approaches remain controversial. Evidence suggests that screening for certain high-risk groups could be beneficial, but untargeted mass screening is not currently recommended. However, whether the benefits of an early diagnosis would overcome the challenges of lifelong dietary treatment, especially in asymptomatic individuals who consider themselves healthy, are unclear.
Conclusion:
There is moderate evidence that screening certain at-risk groups for coeliac disease could be beneficial, but more studies in different settings are needed before large-scale population screening can be recommended.
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