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Celiac disease is more widespread than we thought — and better testing is why. A new meta-analysis of nearly 400,000 people across 39 countries found that combining multiple antibody tests boosts celiac disease detection by about 40% compared to using a single test. The global seroprevalence jumped from 1.5% with one test to 2.1% with combined screening, suggesting millions of cases may be going undetected.
Celiac disease is more widespread than we thought — and better testing is why. A large systematic review and meta-analysis published in Gastroenterology analyzed 87 studies involving nearly 400,000 participants across 39 countries and found that the global prevalence of celiac disease (CeD) has been consistently underestimated when relying on a single serologic test.
The culprit? Most screening programs rely solely on tissue transglutaminase antibodies (tTG-IgA), but adding other markers — like endomysial antibodies or deamidated gliadin peptide (DGP) tests — paints a much fuller picture. In fact, studies using tTG-IgA combined with DGP-IgG found that skipping the DGP-IgG test could miss roughly half of seropositive patients.
By the Numbers:
Why it matters: With nearly half of confirmed cases being asymptomatic, celiac disease is a silent epidemic hiding in plain sight. Clinicians relying on a single antibody test may be missing a substantial portion of patients — underscoring the urgent need for standardized, multi-marker screening protocols worldwide.
