[Health Care professionals seem to have differing opinions on whether or not to screen people who do not present with symptoms, for Celiac Disease (CD). A task force looked at whether there was enough evidence to determine whether testing of people without symptoms provided any benefit or harm for patients, their findings were reported by JAMA (The Journal of the American Medical Association). Basically there is insufficient evidence to recommend or not recommend that patients who do not present with symptoms be screened for CD. More data is needed! These results are primarily for the medical community and certainly if you feel you should be tested for CD for any reason, have symptoms or do not have symptoms, discuss with your health care professional, particularly if you are an at-risk family member!]
Date: 28 March 2017
Source: The JAMA Network services
Reported in the March 28 issue of JAMA.
Objective To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for celiac disease.
Conclusions and Recommendation 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. (see below I statement)
[Credit: Video courtesy of The JAMA Network ®; © 2017 American Medical Association]
JAMA
This is an I statement, indicating that evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.
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 inflammatory damage to the small intestine, which can cause gastrointestinal and nongastrointestinal illness. The estimated prevalence among U.S. adults ranges from 0.40% to 0.95%.
To issue a new recommendation, the USPSTF reviewed the evidence on the accuracy of screening for celiac disease in asymptomatic adults, adolescents, and children; the potential benefits and harms of screening vs not screening and targeted vs universal screening; and the benefits and harms of treatment of screen-detected celiac disease.
The USPSTF is an independent, volunteer panel of experts that makes recommendations about the effectiveness of specific preventive care services such as screenings, counseling services, and preventive medications.
Detection
The USPSTF found inadequate evidence regarding the accuracy of screening tests for celiac disease in asymptomatic populations.
Benefits of Early Detection and Intervention or Treatment
The USPSTF found inadequate evidence on the effectiveness of screening for celiac disease in asymptomatic adults, adolescents, and children with regard to morbidity, mortality, or quality of life. The USPSTF also found inadequate evidence on the effectiveness of targeted screening in persons who are at increased risk for celiac disease (e.g., persons with family history or other risk factors), or on the effectiveness of treatment of screen-detected, asymptomatic celiac disease to improve morbidity, mortality, or quality of life compared with no treatment or treatment initiated after clinical diagnosis.
Harms of Early Detection and Intervention or Treatment
The USPSTF found inadequate evidence on the harms of screening for or treatment of celiac disease.
Read full article here
Note recommendations for screening by other agencies mentioned in the article (The American Academy of Family Physicians, The National Institute for Health and Care Excellence, The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition)
Read Editorial here
