Italian screening study finds increasing prevalence of celiac disease

June 8, 2021

Mass screening program finds high rates of celiac disease in children

 

By Maria Luci, assistant director of digital media

A new celiac disease study is adding support to the idea that mass screening may lead to significantly higher rates of diagnosis in children. Researchers in Italy found rates of childhood celiac disease have risen over the past several decades. According to the abstract of a new childhood mass screening study, CELI SCREEN, the rate of celiac disease in Italian children has doubled over the last twenty-five years when compared to an earlier study of the same age group. The abstract was presented at the 6th World Congress of Paediatric Gastroenterology, Hepatology and Nutrition and does not provide any further results of the study, its methods and findings. More information will be available once the research is published in a journal. 

Screenings Find Increasing Prevalence

It has long been believed that the prevalence of celiac disease is 1% of the global population, however recent screening studies such as CELI SCREEN in Italy and the Autoimmunity Screening for Kids (ASK) study in Colorado, are finding higher prevalence numbers. The program screened 7,760 children ages five to 11 across Italy, while ASK screened 9,973 children in Colorado. According to the CELI SCREEN study authors, the overall prevalence of celiac disease in the Italian school children they screened was 1.6%.

Currently, it is estimated that between 50-83% of those with celiac disease remain undiagnosed or misdiagnosed. Undiagnosed celiac disease can lead to a number of serious conditions such as anemia, infertility and even certain cancers. Early diagnosis helps prevent worsening symptoms, damage and suffering. Studies such as CELI SCREEN and ASK both highlight the need for better screening measures to increase diagnosis rates. 

Diagnostic Criteria Differences

One notable difference between the ASK and CELI SCREEN studies are their methods for determining a final diagnosis for celiac disease. While ASK found 2.4% of the children screened had elevated antibody levels, they used an endoscopic biopsy to confirm diagnosis. This brought the final prevalence number to at least 1.5% (of the 242 positive blood screens, 185 children returned for a follow-up biopsy and 149 were ultimately diagnosed with celiac disease). The CELI SCREEN Study followed ESPGHAN (European Society for Paediatric, Gastroenterology, Hepatology and Nutrition) guidelines for diagnosis, which doesn’t require a biopsy for diagnosing children with celiac disease when antibody levels are above a certain threshold. Therefore, the final prevalence numbers for each study may not be completely comparable. 

Screening to Increase Diagnosis

Lead author Elena Lionetti, MD, PhD, said in a press release that “the study showed that screening in childhood leads to more cases of coeliac disease being diagnosed than in standard care (where children are tested if they present with symptoms, or are screened because of a family history of the disease).”

If the CELI SCREEN study findings hold up to peer review, it would be more evidence that the prevalence of celiac disease is increasing and that there is a need for better screening. 

You can read a press release about the study here.

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