To screen or not to screen

By Jason Clevenger

Summary: A study by Stanford University researchers suggests that mass-screening of celiac disease in adolescents is not as cost-effective as selective screening of at-risk individuals.

The authors determined that a universal screening strategy doesn’t increase the long-term quality of life of the general population and potentially introduces harm from unnecessary endoscopic examinations. They did this by examining the long-term costs associated with undiagnosed celiac disease, including bone density loss and increased likelihood of bone fractures.

Conclusion: The authors conclude that concern in medical community about the hidden dangers of undiagnosed “silent” celiac disease may still not warrant universal screening, at least with respect to bone density and fracture risk. They note that further analysis of risk and cost for other consequences of undiagnosed celiac disease such as anemia, infertility and cancer may change the balance regarding the value of universal screening.


[1] “Cost-effectiveness of Universal Serologic Screening to Prevent Nontraumatic Hip and Vertebral Fractures in Patients With Celiac Disease.”, Park KT, Tsai R, Wang L, Khavari N, Bachrach L, Bass D., #Clinical Gastroenterology and Hepatology# 2013 Jun;11(6):645-53.