Published 17 September 2009, doi:10.1136/bmj.b3592
Cite this as: BMJ 2009;339:b3592

Head to Head

Should we screen for coeliac disease? Yes

¹ Mucosal Biology Research Center and Center for Celiac Research, University of Maryland School of Medicine, Baltimore, MD 21201, USA

Coeliac disease often goes undiagnosed. Alessio Fasano argues that screening would prevent considerable morbidity, but Kate Evans and colleagues (doi:10.1136/bmj.b3674) think we do not know enough about the effects on people without symptoms

The first 150 words of the full text of this article appear below.

Coeliac disease is an immune mediated enteropathy triggered by the ingestion of gluten, the major protein component of wheat, and related proteins in rye and barley, in genetically susceptible individuals.¹ It is one of the most common lifelong disorders, affecting 0.5-1% of the population.² Many of those affected are not diagnosed because of the wide spectrum of clinical presentations. People who remain undiagnosed are at risk of long term complications, including infertility, osteoporosis, and lymphoma. Therefore prompt diagnosis is important not only to enable appropriate treatment of symptoms but to prevent future complications. Since diagnosis currently takes 7-10 years,³ serological screening will increase the quality of life for many people.

Increased awareness of the disease, coupled with a low threshold for serological testing, will undoubtedly uncover a large portion of those with undiagnosed disease. What remains to be established by cost effectiveness analyses is whether we should adopt mass screening . . . [Full text of this article]

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Relevant Article

Should we screen for coeliac disease? No

Kate E Evans, Ruth McAllister, and David S Sanders
BMJ 2009 339: b3674. [Extract] [Full Text]

Rapid Responses:

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Screening for coeliac disease should be done

Antonio Tursi
bmj.com, 24 Sep 2009 [Full text]

Another benefit

Stephen R Workman
bmj.com, 30 Oct 2009 [Full text]

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