Naredi Scherman Maria, Melin Jessica, Agardh Daniel
Celiac Disease and Diabetes Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Front Pediatr. 2025 Apr 3;13:1562073. doi: 10.3389/fped.2025.1562073. eCollection 2025.
Comprehensive screening of the general population is the only approach capable of identifying the majority of cases with celiac disease. In 2023, the Italian Parliament enacted a law to implement nationwide screening for celiac disease and type 1 diabetes. However, critical decisions regarding the target population, optimal timing, and screening methods remain unresolved. Previous observational studies on birth cohorts of children with genetic risk for these conditions have demonstrated that the incidence peaks early in life and is influenced by HLA risk genotypes. This mini-review explores different aspects of screening for celiac disease, presenting the advantages and challenges of identifying children before onset of symptoms. In addition, we summarize the current knowledge and gaps in understanding related to screening programs for celiac disease in children and adolescents and discuss health benefits, psychosocial aspects and cost-effectiveness, and their potential implications for future public health strategies.
对普通人群进行全面筛查是能够识别大多数乳糜泻病例的唯一方法。2023年，意大利议会颁布了一项法律，以在全国范围内开展乳糜泻和1型糖尿病筛查。然而，关于目标人群、最佳筛查时间和筛查方法的关键决策仍未解决。此前针对有这些疾病遗传风险的儿童出生队列进行的观察性研究表明，发病率在生命早期达到峰值，并受HLA风险基因型影响。本综述探讨了乳糜泻筛查的不同方面，介绍了在症状出现前识别儿童的优势和挑战。此外，我们总结了目前关于儿童和青少年乳糜泻筛查项目的认识和理解上的差距，并讨论了健康益处、心理社会方面和成本效益，以及它们对未来公共卫生策略的潜在影响。
