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March 28, 2017

The US Preventive Services Task Force Recommendation on Screening for Asymptomatic Celiac Disease: A Dearth of Evidence

Author Affiliations
  • 1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota

Copyright 2017 American Medical Association. All Rights Reserved.

JAMA. 2017;317(12):1221-1223. doi:10.1001/jama.2017.1105

In this issue of JAMA, the US Preventive Services Task Force (USPSTF) critically examines screening for celiac disease in asymptomatic adults, adolescents, and children.1,2 Celiac disease, one of the most common lifelong disorders in the United States, exhibits a broad spectrum of clinical presentations from subtle or no symptoms to severe malabsorption. The rate of diagnosis of celiac disease has substantially increased over the past 30 years, in part explained by increased awareness but perhaps also by a true increase in the disease. The current prevalence of celiac disease is estimated at 0.71% among US adults and 0.76% among US children.3 However, most celiac disease in the population remains undetected, despite wide availability of accurate serologic tests for the disease. Screening could be one option to detect this condition, especially among populations at high risk of celiac disease but who have not yet developed symptoms. The USPSTF, having set an appropriately high bar, concludes that “the current evidence is insufficient to assess the balance of benefits and harms of screening for celiac disease in asymptomatic persons (I statement)”1 and has recommended that more research is needed in this area.