Screening at-risk adolescents for celiac disease proves cost-effective

The current standard practice of screening adolescents who are either symptomatic or at high-risk for celiac disease proves to be more cost-effective than universal screening. Additionally, the strategy is successful in preventing bone loss and fractures in celiac patients, according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association.

As many as 70 percent of untreated experience decreased , which can lead to increased risk of osteoporosis and non-traumatic hip and vertebral fractures. Stanford University researchers sought to understand the cost-effectiveness of universal screening for celiac disease versus screening only patients who are at risk for or showing symptoms of celiac disease, given the high risk, and associated costs, of non-traumatic hip and if untreated or undiagnosed.

"Our study showed that conducting systematic screening of patients at risk of celiac disease is more cost effective than screening all adolescents for the disease," said KT Park, MD, MS, division of gastroenterology, hepatology and nutrition, department of pediatrics, Stanford University, and co-lead study author. "We determined that adopting a universal screening strategy fails to increase the long-term quality of life of the population as a whole, and introduces potential harm from unnecessary endoscopic evaluations of healthy individuals."

While the two methods proved similar in lifetime costs and quality of life measurements, screening only those who are at risk or who are showing symptoms was ultimately more cost effective—by a margin of $60— in preventing bone loss and fractures among patients with undiagnosed or subclinical disease.

"There is an ongoing clinical concern in the GI community that the current practice of celiac misses a considerable proportion of asymptomatic patients due to the frequency of silent or inactive disease," added Dr. Park. "However, implementing universal screening to prevent bone disease and subsequent non-traumatic fractures alone in undiagnosed or untreated celiac disease patients does not appear to be a viable health policy alternative to the standard of care."

Further analysis of risk and cost of other potential consequences of undiagnosed and untreated celiac disease, such as anemia, infertility and malignancy, could change the cost-effectiveness of for celiac disease.

add to favorites email to friend print save as pdf

Related Stories

Medical follow-up in celiac disease is less than optimal

Jul 25, 2012

Follow-up exams for patients with celiac disease are often inadequate and highly variable, according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastro ...

Celiac 'epidemics' link to infections early in life

Dec 18, 2012

Celiac disease affects about one percent of the population but occasional 'epidemics' have been noticed along with a seasonal variation in number of cases diagnosed. New research published in BioMed Central's open access ...

Recommended for you

Africa's uneven health care becomes easy prey for Ebola

6 hours ago

Threatened by the possible spread of an Ebola epidemic which respects no borders, Africa is divided between a handful of countries equipped to withstand an outbreak and many more which would be devastated, experts say.

Ebola case stokes concerns for Liberians in Texas

7 hours ago

The first case of Ebola diagnosed in the U.S. has been confirmed in a man who recently traveled from Liberia to Dallas, sending chills through the area's West African community whose leaders urged caution ...

Is Australia prepared for Ebola?

10 hours ago

Australia needs to be proactive about potential disease outbreaks like Ebola and establish a national centre for disease control.

User comments