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Coeliac disease (CD) is an immune mediated enteropathy triggered by ingestion of gluten containing grains in genetically susceptible individuals.1 CD is associated with HLA alleles DQ2 and/or DQ8, and in the continued presence of gluten the disease is self perpetuating.1,2 To sustain the position that active screening in search of CD cases is a justified policy, we will review the WHO guidelines for disease mass screening recommendations to establish whether CD satisfies these criteria.3
WHO CRITERIA FOR MASS SCREENINGS
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Early detection of the disease could be difficult on a clinical basis.
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The disease must be a common disorder causing significant morbidity in the general population.
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The screening tests must be highly sensitive and specific for the target disease.
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A treatment for the disease must be available.
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If not recognised, the disease could result in severe complications difficult to manage.
EARLY DETECTION
CD can manifest with a previously unsuspected range of clinical presentations, including the typical malabsorption syndrome (chronic diarrhoea, weight loss, abdominal distension) and a spectrum of symptoms …