Diagnostic delay in adult coeliac disease: An Italian multicentre study

Background: There are few data regarding the diagnostic delay and its predisposing factors in coeliac disease (CD).Aims: To investigate the overall, the patient-dependant, and the physician-dependant diagnostic delays in CD.Methods: CD adult patients were retrospectively enroled at 19 Italian CD outpatient clinics (2011-2021). Overall, patient-dependant, and physician-dependant diagnostic delays were assessed. Extreme diagnostic, i.e., lying above the third quartile of our population, was also analysed. Multivariable regression models for factors affecting the delay were fitted.Results: Overall, 2362 CD patients (median age at diagnosis 38 years, IQR 27-46; M:F ratio = 1:3) were included. The median overall diagnostic delay was 8 months (IQR 5-14), while patient-and physician -dependant delays were 3 (IQR 2-6) and 4 (IQR 2-6) months, respectively. Previous misdiagnosis was associated with greater physician-dependant (1.076, p = 0.005) and overall (0.659, p = 0.001) diagnos-tic delays. Neurological symptoms (odds ratio 2.311, p = 0.005) and a previous misdiagnosis (coefficient 9.807, p = 0.0 0 0) were associated with a greater extreme physician-dependant delay. Gastrointestinal symptoms (OR 1.880, p = 0.004), neurological symptoms (OR 2.313, p = 0.042), and previous misdiagno-sis (OR 4.265, p = 0.0 0 0) were associated with increased extreme overall diagnostic delay.Conclusion: We identified some factors that hamper CD diagnosis. A proper screening strategy for CD should be implemented.& COPY; 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.