Factors associated with long diagnostic delay in celiac disease.
OBJECTIVE
Here, we investigated the factors associated with long diagnostic delay in celiac disease and the impact of the national Current Care Guidelines in reducing the delay.


MATERIAL AND METHODS
This population-based study involved 825 adult celiac disease patients. The diagnosis was considered delayed when the interval between first symptoms and diagnosis was >10 years. The patients were asked about the duration and type of symptoms before diagnosis, time and site (tertiary, secondary, or primary care) of the diagnosis, family history of the disease, and presence of significant comorbidities. Analysis was performed by binary logistic regression.


RESULTS
Altogether, 261 (32%) out of 825 participants reported a diagnostic delay of >10 years. Female gender, neurological or musculoskeletal disorders and presence of diarrhea, abdominal pain, and malabsorption were associated with prolonged delay. Male gender, diagnosis after the introduction of the first Current Care Guidelines in 1997, and being detected by serological screening, and family history of celiac disease were associated with a lower risk of delayed diagnosis. Factors not associated with the delay were site of diagnosis, age, and presence of dermatitis herpetiformis, type 1 diabetes, or thyroidal disease.


CONCLUSION
The number of long diagnostic delays in celiac disease has decreased over the past decades. The shift of diagnostics from secondary and tertiary care to primary care has not been detrimental. National guidelines together with increased awareness and active screening in at-risk groups of celiac disease are important in these circumstances.
['Fuchs|Valma|V|', 'Kurppa|Kalle|K|', 'Huhtala|Heini|H|', 'Collin|Pekka|P|', 'Mäki|Markku|M|', 'Kaukinen|Katri|K|']
D000328:Adult D002446:Celiac Disease D057210:Delayed Diagnosis D005260:Female D005387:Finland D005500:Follow-Up Studies D006801:Humans D015994:Incidence D008297:Male D011159:Population Surveillance D012307:Risk Factors D013997:Time Factors
diagnostic delay celiac disease current care guidelines adults