Screening for Celiac Disease: US Preventive Services Task Force Recommendation Statement

@article{BibbinsDomingo2017ScreeningFC,
  title={Screening for Celiac Disease: US Preventive Services Task Force Recommendation Statement},
  author={Kirsten Bibbins-Domingo and David C. Grossman and Susan J Curry and Michael J. Barry and Karina W. Davidson and Chyke A Doubeni and Mark H. Ebell and John W Epling and Jessica Herzstein and Alex R. Kemper and Alex H. Krist and Ann E. Kurth and C. Seth Landefeld and Carol M. Mangione and Maureen G. Phipps and Michael Silverstein and Melissa A. Simon and Chien-Wen Tseng},
  journal={JAMA},
  year={2017},
  volume={317},
  pages={1252–1257}
}
Importance Celiac disease is caused by an immune response in persons who are genetically susceptible to dietary gluten, a protein complex found in wheat, rye, and barley. Ingestion of gluten by persons with celiac disease causes immune-mediated inflammatory damage to the small intestine. Objective To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for celiac disease. Evidence Review The USPSTF reviewed the evidence on the accuracy of screening in asymptomatic… 
View on Wolters Kluwer
jamanetwork.com
58 Citations
Highly Influential Citations
1
Background Citations
9

Figures from this paper

58 Citations

The US Preventive Services Task Force Recommendation on Screening for Asymptomatic Celiac Disease: A Dearth of Evidence.
TLDR
The USPSTF concludes that “the current evidence is insufficient to assess the balance of benefits and harms of screening for celiac disease in asymptomatic persons” and has recommended that more research is needed in this area.
Celiac Disease and Nonceliac Gluten Sensitivity: A Review
TLDR
Although both conditions are treated with a gluten-free diet, distinguishing between celiac disease and nonceliac gluten sensitivity is important for long-term therapy.
Celiac Disease Screening for High-Risk Groups: Are We Doing It Right?
TLDR
Although screening for CD with serological tests is not recommended for the general population, it should be considered in these special populations that are at high risk of developing CD due to shared genetic susceptibilities.
Celiac disease: clinical update
TLDR
Current understanding of celiac disease continues to advance, though significant knowledge gaps remain and large, rigorous, prospectively designed studies are needed to further characterize Celiac disease pathogenesis, management and therapeutic options.
The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options
TLDR
The most effective treatment for CD is a gluten-free diet, but work on non-dietary therapy is in process and few medications are in the clinical trial phase.
Epidemiology, Presentation, and Diagnosis of Celiac Disease.
TLDR
If proven accurate and scalable, assays that detect gluten-HLA tetramer complexes might be used in diagnosis to be made in the context of a gluten-free diet, without intestinal biopsy.
Routine Screening for Celiac Disease in Children with Down Syndrome Improves Case Finding.
TLDR
The results suggest the need for routine celiac disease screening in children with Down syndrome to improve case-finding and avoid diagnostic delay.
Prevalence of occult celiac disease in females with iron deficiency in the United States: an NHANES analysis
TLDR
The overall prevalence of celiac disease in the USA’ female population is low, however, the prevalence is higher in subjects with iron deficiency, and the prevalence of CD was higher in female subjects with ID.
Low Rates of Screening for Celiac Disease Among Family Members
Accuracy of Screening Tests for Celiac Disease in Asymptomatic Patients With Type 1 Diabetes.
TLDR
Thresholds extrapolated from the general population for the diagnostic evaluation of celiac disease are not suitable for use in asymptomatic T1D patients and population-specific screening cutoffs are required.
...
...

References

SHOWING 1-10 OF 32 REFERENCES
Screening for Celiac Disease: Evidence Report and Systematic Review for the US Preventive Services Task Force
TLDR
Little or no evidence was identified to inform most of the key questions related to benefits and harms of screening for celiac disease in asymptomatic individuals, and more research is needed to understand the effectiveness of screening and treatment for Celiac disease, accuracy of screening tests in asylptomatic persons, and optimal screening strategies.
ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease
TLDR
Given the incomplete response of many patients to a GFD-free diet as well as the difficulty of adherence to the GFD over the long term, development of new effective therapies for symptom control and reversal of inflammation and organ damage are needed.
Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition.
TLDR
It is recommended that children and adolescents with symptoms of celiac disease or an increased risk for Celiac disease have a blood test for antibody to tissue transglutaminase (TTG), and that those with an elevated TTG be referred to a pediatric gastroenterologist for an intestinal biopsy and treated with a strict gluten-free diet.
Benefits of a gluten-free diet for asymptomatic patients with serologic markers of celiac disease.
TLDR
GFDs benefit asymptomatic EmA-positive patients and support active screening of patients at risk for celiac disease, as well as those placed on gluten-containing diets.
Prevalence of Celiac disease among children in Finland.
TLDR
The presence of serum tissue transglutaminase and endomysial autoantibodies is predictive of small-bowel abnormalities indicative of celiac disease and there is a good correlation betweenAutoantibody positivity and specific HLA haplotypes.
Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study.
TLDR
The results suggest that CD occurs frequently not only in patients with gastrointestinal symptoms, but also in first- and second-degree relatives and patients with numerous common disorders even in the absence of gastrointestinal symptoms.
Clinical presentation of celiac disease in the pediatric population.
TLDR
There is growing interest in the social aspects of CD because the burden of illness related to this condition is doubtless higher than previously thought.
Symptom positivity is essential for omitting biopsy in children with suspected celiac disease according to the new ESPGHAN guidelines
TLDR
The results reveal that intestinal biopsies could be omitted in 28 % of patients when the new ESPGHAN guidelines are applied, and the new guideline seems to be applicable even without the use of HLA testing.
Long-term Health and Quality-of-Life Consequences of Mass Screening for Childhood Celiac Disease: A 10-Year Follow-up Study
TLDR
Identification by mass screening led 10 years later to health improvement in 66% of children without deterioration of generic health-related quality of life and delaying treatment for children without symptoms seems to be an option after a positive screening test.
Recognition and assessment of coeliac disease in children and adults: summary of NICE guidance
TLDR
This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence on the recognition and assessment of coeliac disease and concludes that moderate quality evidence from cohort studies is needed for serological testing to be recommended.
...
...