title: The prevalence of celiac disease in average-risk and at-risk Western European populations: a systematic review.
abstract: Until recently, celiac disease (CD) was felt to be a rare disease in the United States. The aim of this study was to conduct a systematic review of the prevalence of CD in general Western populations and in populations at high risk for CD. Standard systematic review methodology was used. A literature search was conducted in MEDLINE (1966 to October 2003) and EMBASE (1974 to December 2003) databases. Qualitative and quantitative prevalence estimates were produced after assessing study heterogeneity. The prevalence of CD in general Western populations is close to 1% and is somewhat higher in certain Western European populations. The prevalence of CD in populations at risk for CD is as follows: 3%-6% in type 1 diabetic patients, up to 20% in first-degree relatives, 10%-15% in symptomatic iron-deficiency anemia (IDA), 3%-6% in asymptomatic IDA, and 1%-3% in osteoporosis. The prevalence of CD in patients suspected of having CD varied depending on the reasons for suspecting CD and on whether the study was conducted in a referral center. In general, the prevalence ranged from 5% to 15%, but was up to 50% in symptomatic patients evaluated in a tertiary referral center. CD is a common medical condition. The prevalence is higher still in high-risk groups. Clinicians in a variety of specialties should have a high index of suspicion for the diagnosis of CD and in particular need to pay close attention to the identified high-risk groups.
authors.affiliation: Gastrointestinal Clinical Research Unit, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Dubé
authors.forename: Alaa
authors.initials: A
authors.lastname: Rostom
authors.forename: Richmond
authors.initials: R
authors.lastname: Sy
authors.forename: Ann
authors.initials: A
authors.lastname: Cranney
authors.forename: Navaaz
authors.initials: N
authors.lastname: Saloojee
authors.forename: Chantelle
authors.initials: C
authors.lastname: Garritty
authors.forename: Margaret
authors.initials: M
authors.lastname: Sampson
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Yazdi
authors.forename: Vasil
authors.initials: V
authors.lastname: Mamaladze
authors.forename: Irene
authors.initials: I
authors.lastname: Pan
authors.forename: Joanne
authors.initials: J
authors.lastname: Macneil
authors.forename: David
authors.initials: D
authors.lastname: Mack
authors.forename: Dilip
authors.initials: D
authors.lastname: Patel
authors.forename: David
authors.initials: D
authors.lastname: Moher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000209:etiology; D002446:Celiac Disease / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology