Study findings demonstrate benefit to pediatric celiac disease mass screening

The Children's Hospital Colorado's (Children's Colorado) Autoimmunity Screening for Kids (ASK) study has released its findings in support of mass screening for pediatric celiac disease. To date, there has been insufficient evidence for recommending mass screening for celiac disease, even though many children who have celiac may not show typical symptoms, which can lead to a delay in diagnosis.

Celiac disease is one of the most common pediatric autoimmune diseases in the United States. The chronic irritation of the small intestine is triggered by exposure to gluten found in food by people predisposed genetically to celiac disease.

While screening studies in Europe have supported similar conclusions, this study is the first to look at outcomes in the United States, providing much-needed data to inform the case for pediatric mass screening for celiac disease.

The ASK study is a pediatric mass screening program for type 1 diabetes and celiac disease in Colorado. Celiac disease diagnosis and treatment following ASK mass screening led to improvements for potential pediatric mass screening for celiac disease in the United States. A one-year follow-up of children diagnosed with celiac disease through the ASK study, and treated with a gluten-free diet, showed an improvement in symptoms, quality of life and iron deficiency.

The dedication of our study participants and the follow-up and completion of study surveys, despite this study occurring during the pandemic, allowed for a very comprehensive study," said Marisa Stahl, MD, gastroenterologist at Children's Colorado and primary author of the study. "Families were very willing to participate and felt positively about the study."

The study followed 52 children with celiac disease, ages 1-17 years old, who screened positive for antibodies in the ASK study, which prompted further diagnostic evaluation. Children diagnosed with celiac disease by biopsy or by blood testing were also included in this study. Study participant symptoms were carefully monitored, as well as the impact on the family, health-related quality of life and mental health.

"The celiac disease field may be headed towards mass screening in children, and it is studies like ASK that will inform us about the risks and benefits of screening, including how to conduct it in a responsible manner," said Edwin Liu, MD, pediatric gastroenterologist and director, Colorado Center for Celiac Disease.

The paper is published in the journal Clinical Gastroenterology and Hepatology.