I read with interest the debate on population based screening for coeliac disease (Gut 2003:52;168–9 and 170–1). Antagonists of population based screening hold the view that there is no evidence that screening the general population or instituting a gluten free diet in asymptomatic coeliac disease will reduce mortality.

Contrary to early beliefs, coeliac disease is one of the most common disorders affecting up to 1% of the general population, regardless of ethnic or geographical origin. In patients with coeliac disease, mortality rate is higher than the general population by a factor of 1.9–3.8, mainly due to complications (table 1) such as malignancy.^1–3