title: Is coeliac disease screening in risk groups justified? A fourteen-year follow-up with special focus on compliance and quality of life.
abstract: BACKGROUND
  The benefits of serologic screening for coeliac disease in asymptomatic individuals are debatable.
  
  
  OBJECTIVE
  To investigate dietary compliance, quality of life and bone mineral density after long-term treatment in coeliac disease patients found by screening in risk groups.
  
  
  METHODS
  The study comprised 53 consecutive screen-detected coeliac patients diagnosed 14 years (median) ago. Dietary compliance was assessed by interview, 4-day food record and serology. Quality of life was evaluated by the Psychological General Well-Being and SF-36 questionnaires, gastrointestinal symptoms by the Gastrointestinal Symptom Rating Scale and bone mineral density by dual-energy x-ray absorptiometry. Comparisons were made to 44 symptom-detected-treated coeliac patients, 110 non-coeliac subjects and the general population.
  
  
  RESULTS
  A total of 96% of screen-detected and 93% of symptom-detected coeliac patients adhered to a strict or fairly strict gluten-free diet. In screen-detected patients, quality of life and gastrointestinal symptoms were similar to those in symptom-detected patients or non-coeliac controls and bone mineral density was similar to that in the general population.
  
  
  CONCLUSIONS
  Long-term dietary compliance in screen-detected patients was good. Quality of life and bone mineral density were comparable with those in non-coeliac subjects and the general population. Active screening in coeliac disease risk groups seems to be reasonable rather than harmful.
authors.affiliation: Department of Gastroenterology, Tampere University Hospital, UKK Institute for Health Promotion Research, School of Public Health, Medical School, University of Tampere, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Viljamaa
authors.forename: P
authors.initials: P
authors.lastname: Collin
authors.forename: H
authors.initials: H
authors.lastname: Huhtala
authors.forename: H
authors.initials: H
authors.lastname: Sievänen
authors.forename: M
authors.initials: M
authors.lastname: Mäki
authors.forename: K
authors.initials: K
authors.lastname: Kaukinen
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015519:Bone Density; D002446:Celiac Disease / Q000178:diet therapy / Q000517:prevention & control*; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010349:Patient Compliance; D011788:Quality of Life; D012307:Risk Factors