The incidence and prevalence of celiac disease (CeD) increased significantly in the United States military population from 2000 to 2021, according to a study in Digestive Diseases and Sciences.
The retrospective, population-based cohort study is based on data from the Defense Medical Surveillance System from January 1, 2000 through December 31, 2021. Participants included active-duty military service members of the US Army, Navy, Air Force, and Marine Corps who served during the study period.
Annual incidence rates and disease prevalence were calculated and reported per 100,000 service members.
A total of 2,248 military members were newly diagnosed with CeD during the study period. The annual incidence increased from 1.2 per 100,000 to 14.0 per 100,000 person-years in 2000 and 2021, respectively. For gastroenterology specialty clinics, the incidence increased from 1.4 per 100,000 in 2000 to 8.2 per 100,000 person-years in 2021.
The prevalence increased from 3.1 per 100,000 members in 2000 to 57.4 per 100,000 members in 2021. After stratification according to gastroenterology clinic diagnosis, the prevalence rates increased from 3.3 to 33.4 per 100,000 service members.
Women (28.2 and 110.4), White non-Hispanic individuals (18.0 and 80.4), and service members aged 46 years (43.8 and 228.5) and older had the highest incidence and prevalence rates, respectively, in 2021. The Air Force had the highest incidence (18.2) and prevalence rates (84.9) in 2021, and the Marine Corps had the lowest rates (8.9 and 29.0, respectively).
Study limitations include the inability to complete a chart review for tissue diagnosis of CeD as the gold standard for diagnosis. In addition, the retrospective observational study is based on use of International Classification of Diseases codes.
“The incidence and prevalence of CD [CeD] within the US military is increasing; this can be disqualifying for entry into the military and is of concern for operational readiness and health of our service members,” the study authors wrote. “The incidence and prevalence vary with gender, age, race/ethnicity and branch of service. Further studies are needed to examine the genetic and environmental factors affecting CD and implications for military members.”
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