European and North American populations should be screened for coeliac disease

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Abstract
As European and North American societies become more opulent, the focus of attention moves inevitably from diagnosis and treatment of diseases to screening of populations. Successful screening would require an increased detection of the disease, improvement in the health of that population, and prevention of known complications. Population screening involves testing of otherwise healthy people following an educational programme inviting them to participate with informed consent. If the uptake of this were small, the alternative would be the compulsory testing of body samples allowing little choice to the individual—an action hardly conducive to current societal sentiments! For a screening test to be useful, it needs to be simple, cheap, have a high sensitivity and specificity, and be easy to perform on large numbers of the population. In coeliac disease the endomysial antibody test1 is a possible screening tool. The specificity of this test is approaching 100%2 and sensitivities of 86% or greater have been observed.3,4 Measurement of anti-tissue transglutaminase antibodies (transglutaminase being the principal …