Background: Currently, we are witnessing a diffused ongoing epidemic of CD of great scale. Epidemiological data provide strong evidence of a steady rise in celiac disease (CD) throughout westernized societies over the last six decades. Multiple publications exist, describing past or actual incidences/prevalence of CD, however, long term studies follow-up, on selected populations are scarce. Aims: To calculate the % increases per year of CD incidence worldwide and analyze the differential longitudinal increases of CD per country, and identify geoepidemiological trends.
Methods: A systematic review was performed to identify incidences of CD. Studies from the last 6 decades were identified using Medline, Google, and Cochrane Library databases. Only long-term regional or national long-term follow-ups are reported.
Results: The mean ± s.d. of the net increase in %/year incidence of CD worldwide is 9.77±8.27. In all of these studies, differences between old vs new frequencies were highly significant (p< 0.0001). Geoepidemiologically, Netherland/USA had the highest/lowest net %/year CD incidence increases: 9.23±9.64, 5.0±2.09 respectively. The mean ± s.d. net %/year increases in children was comparable to that depicted in adult populations: 6.6±7.9, 5.2±4.0, respectively p=0.664.The increases were higher in northern/western countries than in southern/eastern countries.
Conclusions: Reviewing available literature, it can be deduced that incidences of CD have increased significantly over the last 60 years. In Canada, Scotland, and Spain the %/year incidence surges were highest while in Estonia, USA and New Zealand it was the lowest. These observations point to a stronger influence of environmental factors as opposed to genetic factors on CD development.
