Published online May 21, 2021. doi: 10.3748/wjg.v27.i19.2251
Peer-review started: January 17, 2021
First decision: February 23, 2021
Revised: February 25, 2021
Accepted: April 13, 2021
Article in press: April 13, 2021
Published online: May 21, 2021
Celiac Disease (CD) had been considered uncommon in Asia for a long time. However, several studies suggested that, in the Indian subcontinent and Middle East countries, CD is present and as prevalent as in Western countries. Outside these Asian regions, the information about the epidemiology of CD is still lacking or largely incomplete for different and variable reasons. Here, we discuss the epidemiological aspects and the diagnostic barriers in several Asian regions including China, Japan, Southeast Asia and Russia/Central Asia. In some of those regions, especially Russia and Central Asia, the prevalence of CD is very likely to be underestimated. Several factors may, to a different extent, contribute to CD underdiagnosis (and, thus, underestimation of its epidemiological burden), including the poor disease awareness among physicians and/or patients, limited access to diagnostic resources, inappropriate use or interpretation of the serological tests, absence of standardized diagnostic and endoscopic protocols, and insufficient expertise in histopathological interpretation.
Core Tip: This editorial discusses the main epidemiological characteristics of Celiac Disease in Asia outside the Indian subcontinent and Middle East countries. Indeed, information about the epidemiology of Celiac Disease is still lacking or largely incomplete in those Asian regions (China, Japan, South-East Asia, and Russia/Centra Asia), where the disease prevalence is likely be underestimated. Factors contributing to diagnostic difficulties in these Asian regions are discussed.