Should we screen everyone for celiac disease?

uspstfThe US Preventive Services Task Force recently reviewed all the relevant research on screening for celiac disease to determine if it makes economic or health sense to screen everyone for the disease. They looked at the accuracy of the screening tests for people of all ages and debated the potential benefit and harm from screening.

The conclusion: there isn’t enough information to make a well-supported decision. There are too many false positive tests to make universal screening appropriate, and we don’t know enough about the benefits and harms of a gluten-free diet on someone with positive blood tests but no symptoms.

They did conclude that it is important to test people with celiac-related symptoms and they defined celiac disease as “a multi-system autoimmune disorder which can have both gastrointestinal symptoms (diarrhea, abdominal pain, and weight loss) and systemic symptoms (anemia, osteoporosis, chronic fatigue, peripheral neuropathy, and ataxia), both of which are improved by following a gluten-free diet”.

That definition of CD alone may remind family doctors that celiac disease is a lot more than just diarrhea. We need to take victories where they come.

Celiac Disease in the News

On December 16, 2009 the Vancouver Sun carried the story “Antibody tests boost celiac disease diagnoses”. It was a story they (and likely many others) picked up from the international wire service Reuters.

Read the full story here.

The Reuters story focused on the findings of a Journal Pediatrics study that found that the rate of celiac disease diagnoses in the study group tripled after the introduction of antibody testing in 2007.

The reported interviewed senior author Dr. J. Decker Butzner, of the University of Calgary and Alberta Children’s Hospital, who described the study’s basic findings.