Over the past few decades, the incidence of celiac disease has increased in many Western countries. A recent review of the existing literature co-authored by Celiac Disease Foundation Young Investigator Award recipient Benjamin Lebwohl, MD, MS, found that overall, the incidence of celiac disease has been rising since the second half of the 20th century into the 21st century in nearly every country where data on the disease are available.

The review looked at data from past research on the incidence (the rate of new cases in a population during a specific period of time) of celiac disease in the overall population, among both children and adults. The studies included in the analysis were based in Europe, North America, and Oceania.

The researchers found that in the 21st century, the incidence of celiac disease was higher among women and children when compared to men. The incidence of celiac disease among women was 17.4 per 100,000 person-years (meaning that among 100,000 women followed for one year, a bit over 17 will be diagnosed with celiac disease), compared to 7.8 per 100,000 person-years among men. Celiac disease incidence among children was 21.3 per 100,000 person-years, compared to 12.9 per 100,000 person-years in adults.

Examination over time shows that these incidence rates are increasing, with an average of 7.5% increase per year over the past several decades. Because the incidence of celiac disease is studied by examining only diagnosed patients, this does not take into account people who remain undiagnosed; there is evidence from other studies that the total number of people with celiac disease (not just diagnosed cases) has increased over time.

There are some possible explanations for the increase in the incidence of celiac disease. The introduction of blood testing towards the end of the 20th century has made diagnosing celiac disease easier and more cost-effective. Additionally, an increase in awareness among physicians has led to evaluating patients with “non-classical” symptoms, rather than only testing patients with traditional gastrointestinal symptoms. The difference in diagnosis rates between men and women may be related to differences in how men and women utilize healthcare, since some screening studies in adults show similar rates of celiac disease in men and women.

Dr. Lebwohl states, “In this comprehensive study on diagnosis rates over space and time, the signal is clear that diagnoses are increasing, which means more people are living with a celiac disease diagnosis today than ever before.” The incidence of celiac disease has been widely studied throughout Europe, North America, and Oceania; however, studies on the incidence of celiac disease in Africa, Asia, and Latin America are scarce. Future population-based studies in these areas are needed to accurately evaluate the global incidence of celiac disease.

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