Has the Rise of Celiac Disease Incidence in Estonian Children Stopped?

The aim of this study was to analyse the incidence and clinical presentation of childhood CD from 2011 to 2020 in Estonia and to compare the incidence with earlier published results of a 35-year period (1976-2010).

Data was collected retrospectively about children up to 19 years of age who were newly diagnosed with CD from 2011 to 2020 in all of Estonia. CD was diagnosed mostly by biopsy and in only two cases by serology.

From 2011 to 2020, 189 new CD cases were diagnosed (113 girls, 60%, M/F ratio 1:1.49). The median age at diagnosis was 8.6 years. For comparison, from 1976 to 2010, the median age was 2.3 years. There were no differences between boys and girls (p = 0.93). Most frequently, the patients had atypical gastrointestinal symptoms. The incidence rate per 100 000 person-years in 2011-2020 was 6.89 (95% CI: 5.94-7.94). For comparison, in 1976-1980, the incidence rate per 100 000 person-years was 0.1.

The median age at diagnosis increased markedly during the study period. From 1976 onward, there has been almost a 70-fold increase in the incidence rate of CD.