Premium
Systematic review and meta‐analysis: the incidence and prevalence of paediatric coeliac disease across Europe
Author(s) -
Roberts Stephen E.,
MorrisonRees Sian,
Thapar Nikhil,
Benninga Marc A.,
Borrelli Osvaldo,
Broekaert Ilse,
Dolinsek Jernej,
MartindeCarpi Javier,
Mas Emmanuel,
Miele Erasmo,
Pienar Corina,
RibesKoninckx Carmen,
Thomassen Rut A.,
Thomson Mike,
Tzivinikos Christos,
Thorne Kymberley,
John Ann,
Williams John G.
Publication year - 2021
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.16337
Subject(s) - medicine , incidence (geometry) , coeliac disease , asymptomatic , disease , pediatrics , epidemiology , prevalence , demography , physics , sociology , optics
Summary Background Coeliac disease is one of the most prevalent immune‐mediated gastrointestinal disorders in children. Aim To review the incidence and prevalence of paediatric coeliac disease, and their trends, regionally across Europe, overall and according to age at diagnosis. Methods Systematic review and meta‐analysis from January 1, 1950 to December 31, 2019, based on PubMed, CINAHL and the Cochrane Library, searches of grey literature and websites and hand searching of reference lists. A total of 127 eligible studies were included. Results The prevalence of previously undiagnosed coeliac disease from screening surveys (histology based) ranged from 0.10% to 3.03% (median = 0.70%), with a significantly increasing annual trend ( P = 0.029). Prevalence since 2000 was significantly higher in northern Europe (1.60%) than in eastern (0.98%), southern (0.69%) and western (0.60%) Europe. Large increases in the incidence of diagnosed coeliac disease across Europe have reached 50 per 100 000 person‐years in Scandinavia, Finland and Spain. The median age at diagnosis increased from 1.9 years before 1990 to 7.6 since 2000. Larger increases in incidence were found in older age groups than in infants and ages <5 years. Conclusions Paediatric coeliac disease incidence and prevalence have risen across Europe and appear highest in Scandinavia, Finland and Spain. The most recent evidence shows large increases in incidence in most regions, but stabilisation in some (notably Sweden and Finland). Sharp increases in the age at diagnosis may reflect increases in milder and asymptomatic cases diagnosed since reliable serology testing became widely used, through endomysial antibodies after 1990 and tissue transglutaminase antibodies around 2000.