Patient and Community Health Global Burden in a World with more Celiac Disease

Celiac disease is one of the commonest life-long disorders worldwide, with a prevalence mostly ranging between 0.7 and 2.9 % in the general population and a higher frequency in females and in well-defined at-risk groups, such as relatives of affected individuals and patients with autoimmune co-morbidities. Increasing clinical detection is facilitated by improving awareness, implementation of a case-finding approach, and serology availability for screening at risk patients, among other factors. Nevertheless, due to huge clinical variability many CeD cases still escape diagnosis in most countries, unless actively searched by proactive policies. The burden of celiac disease is increasing as well as the need for better longitudinal care. Pediatric screening of the general population could represent the road ahead for an efficient intervention of secondary prevention aimed to reduce the social and health burden of celiac disease. This review analyses the epidemiology of celiac disease continent by continent, discusses current strategies to improve the detection of celiac disease, and highlights challenges related to the burden of celiac disease globally.