Increasing prevalence of coeliac disease over time

TLDR

Coeliac disease prevalence has risen, with screening studies indicating about 1% of the population, prompting investigation into whether this reflects a genuine increase. The study aimed to determine whether the rising number of coeliac disease diagnoses represents a true increase in disease frequency. Researchers assessed prevalence using two population-based Finnish samples from 1978‑80 and 2000‑01, incorporating both clinically diagnosed cases and serologically identified previously unrecognized patients. The total prevalence nearly doubled from 1.05% in 1978‑80 to 1.99% in 2000‑01, driven by increases in both clinical and serologically detected cases, and this rise cannot be attributed to improved detection alone.

Abstract

The number of coeliac disease diagnoses has increased in the recent past and according to screening studies, the total prevalence of the disorder is around 1%.To establish whether the increased number of coeliac disease cases reflects a true rise in disease frequency.The total prevalence of coeliac disease was determined in two population-based samples representing the Finnish adult population in 1978-80 and 2000-01 and comprising 8000 and 8028 individuals, respectively. Both clinically-diagnosed coeliac disease patients and previously unrecognized cases identified by serum endomysial antibodies were taken into account.Only two (clinical prevalence of 0.03%) patients had been diagnosed on clinical grounds in 1978-80, in contrast to 32 (0.52%) in 2000-01. The prevalence of earlier unrecognized cases increased statistically significantly from 1.03% to 1.47% during the same period. This yields a total prevalence of coeliac disease of 1.05% in 1978-80 and 1.99% in 2000-01.The total prevalence of coeliac disease seems to have doubled in Finland during the last two decades, and the increase cannot be attributed to the better detection rate. The environmental factors responsible for the increasing prevalence of the disorder are issues for further studies.