Disclosures: Stahl reports no relevant financial disclosures. Please see the study for all other authors' relevant financial disclosures.
January 11, 2021
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Mass screening program finds high prevalence of undiagnosed pediatric celiac disease

Disclosures: Stahl reports no relevant financial disclosures. Please see the study for all other authors' relevant financial disclosures.
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Mass screening identified a high prevalence of celiac disease among children, according to study results.

Marisa G. Stahl, MD, of the department of pediatrics the University of Colorado Anschutz Medical Campus, and colleagues wrote that universal screening for celiac disease (CD) remains controversial in asymptomatic populations. Researchers are conducting the Autoimmunity Screening for Kids (ASK) study to screen children for CD, as well as type 1 diabetes.

“The overall objective of the ASK program is to raise awareness of the importance of type 1 diabetes and CD in the community and to reduce the morbidity of delayed diagnosis associated with these conditions. It will also assess the harms and benets of a mass screening approach.”

In the ASK study, children aged 1 to 17 years undergo screening for CD using two assays for tissue transglutaminase autoantibodies (TGA). Investigators ask children who test positive to return for confirmatory testing.

Among the initial 9,973 children screening in the study, 242 tested positive for TGA with either study. The of 185 children who completed confirmation blood draw, 149 were confirmed positive.

Researchers found that confirmed TGA was associated with a family history of CD (OR = 1.83; 95% CI, 1.06-3.16), non-Hispanic white ethnicity (OR = 3.34; 95% CI, 2.32-4.79) and female sex (OR = 1.43; 95% CI, 1.03-1.98).

Stahl and colleagues found that most children who were identified through screening did not have a family history of CD or symptoms when they were first screened.

“Universal screening seems to be the only way to detect all cases of CD and has the potential to reduce diagnostic delay and associated morbidity,” they wrote. “A longer follow-up period is needed to properly assess the costs of screening and the eect on morbidity and quality of life of screening-identied children and families.”