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We aimed to identify the population-based prevalence of undiagnosed adult CD and examine the impact of a GFD on screen-detected CD. In total, 12,981 adults participated in a population-based health study in Troms\u00f8, Norway. Participants with increased levels of anti-tissue transglutaminase-2 IgA or anti-deamidated gliadin peptide IgG were invited to undergo gastroduodenoscopy with both histological and immunohistochemical examination of small-bowel biopsies. The prevalence of previously diagnosed CD was 0.37%. Additionally, the prevalence of previously undiagnosed CD was 1.10%. Thus, 1.47% of the population had CD, of whom 75% were previously undiagnosed. A GFD resulted in significant improvements in overall gastrointestinal symptoms, diarrhea, and health-related quality of life, with reduced abdominal discomfort (76%) and improved levels of energy (58%). The large majority of patients with adult CD were undiagnosed and benefited from a GFD with reduced gastrointestinal symptoms and improved health-related quality of life. In clinical practice, there should be a low threshold for CD testing even in the absence of abdominal complaints because most adult patients appear to consider their symptoms a part of their normal state and therefore remain untested and undiagnosed.<\/jats:p><jats:p><jats:bold>Trial registration:<\/jats:bold> Clinical Trials. Gov Identifier: NCT01695681.<\/jats:p>","DOI":"10.1038\/s41598-022-16705-2","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T12:04:28Z","timestamp":1658750668000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Population-based screening for celiac disease reveals that the majority of patients are undiagnosed and improve on a gluten-free diet"],"prefix":"10.1038","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct01695681","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Jan-Magnus","family":"Kvamme","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sveinung","family":"S\u00f8rbye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Florholmen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trond S.","family":"Halstensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,25]]},"reference":[{"key":"16705_CR1","doi-asserted-by":"publisher","first-page":"1731","DOI":"10.1056\/NEJMra071600","volume":"357","author":"PHR Green","year":"2007","unstructured":"Green, P. 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Halstensen has served as speaker, consultant, and head of the scientific board of the Norwegian Celiac Disease association. He has also served as a speaker for Phadia. Jan-Magnus Kvamme has served as a speaker for the Norwegian Celiac Disease association. Jon Florholmen and Sveinung W S\u00f8rbye declare no personal interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"12647"}}