title: Screening for coeliac disease--has the time come for mass screening?
abstract: Several recent studies, in particular the Italian SIGEP study, have demonstrated that mass screening for coeliac disease using gliadin and endomysial antibody testing is now a realistic possibility. If mass screening is to receive serious consideration then it must be shown to be (i) effective, (ii) acceptable, and (iii) worthwhile (cost-effective). At present there is insufficient evidence as to the health benefits from treating screen-detected disease and as to the size of the risks associated with having undetected coeliac disease. It is also unclear whether truly asymptomatic screen-detected coeliacs will accept long-term dietary restriction. To answer these questions randomized trials of screening are needed. On current evidence, mass screening cannot be justified. Efficient case-finding may prove as effective and more acceptable.
authors.affiliation: University of Nottingham Medical School, Queen's Medical Centre, UK.
authors.forename: R F
authors.initials: RF
authors.lastname: Logan
mesh_terms: D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004035:Diet Therapy / Q000009:adverse effects; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000592:standards*; D010349:Patient Compliance; D015995:Prevalence; D011634:Public Health / Q000379:methods / Q000592:standards