Celiac disease (CD)
Celiac disease: prevalence and incidence
Celiac disease, previously referred to as endemic sprue is one of the most common autoimmune diseases worldwide. Its prevalence varies from country to country and, according to screening studies, is estimated to range from 0.7% to 2.9%, averaging approximately 1%. Females are disproportionately affected compared to males, with a ratio of between 1:3 and 1.5:1. An increased prevalence is also seen in first-degree relatives (10-15%) and other risk groups, especially in people with other autoimmune diseases, Down syndrome, type 1 diabetes, or IgA deficiency.
Why is the incidence of celiac disease steadily increasing?
Historically, celiac disease was considered a rare disease typical of European countries, with an estimated prevalence of 1:4000-1:8000. The development of sensitive and simple diagnostic tools such as serological testing for tissue transglutaminase (TTG) IgA antibodies and the further development of screening tests in recent years have shown that celiac disease is much more common than previously thought. According to a meta-analysis from 2020, the incidence of celiac disease has shown an average annual increase of 7.5% over the last few decades. The overall incidence of celiac disease in Europe is now above 12.7 per 100,000 in most European countries.
Is there an age peak for the first onset of celiac disease?
Celiac disease may present at any age, from early childhood to old age. There are two age peaks: the first occurs after gluten is introduced within the first two years of life, while the second is observed in the second or third decade of life.
Why do we talk about the celiac disease diagnosis iceberg?
Only 10% to 20% of individuals with celiac disease exhibit the classic, fully developed form of the condition. The majority of those affected have atypical symptoms, few or none at all, and are therefore often unaware of the disease. This is why celiac disease is often referred to as the "iceberg diagnosis." Despite increased awareness and improved diagnostic options in recent years, according to the German Celiac Society, 80-90% of cases remain undiagnosed in Germany. The mostly heterogeneous symptoms of celiac disease are a major factor in the delay in diagnosis. According to an international online survey conducted by Dr. Schär's internal database, the mean duration from initial symptom onset to diagnosis of celiac disease is 4.8 years.
Dr. Schär Institute Newsletter
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