Osteoporosis experts urge bone density testing more frequently for women at risk

Although a recent study suggests that women with normal results on dual-energy X-ray absorptiometry (DXA) scans at ages 67 and older may wait up to 15 years for a second test, a Viewpoint article published today in the Journal of Bone and Mineral Research (JBMR) cautions that such a lengthy interval is inappropriate for many adults.

Viewpoints allow experts to provide a new perspective on research. In their article, osteoporosis experts Drs. E. Michael Lewiecki, Andrew Laster, Paul Miller and John Bilezikian write that monitoring bone mineral density by DXA should be done at intervals much shorter than 15 years for many individuals. These include younger at high risk for fracture, patients whose DXA scans indicate bone mineral density values substantially below normal, those with prior fracture or clinical risk factors for fracture, and patients already receiving therapy.

The article comments on research recently published in the (NEJM).

"Policy makers and patients who are concerned that over-use of medical tests may be driving up health care costs may be tempted to conclude that DXA scanning should be done less frequently," said Dr. Lewiecki. "In fact, just the opposite is true. Appropriate DXA screening reduces health care costs."

Many women, even those at risk for osteoporosis, never receive an initial DXA screening, the authors of the JBMR article note, with the result that osteoporosis often goes undiagnosed and untreated leading to debilitating fractures that are dangerous to patients and costly to treat. Over 200 million people worldwide suffer from osteoporosis, including 10 million Americans, with two million related fractures occurring annually and treatment costs exceeding $18 billion.

While the authors agree that a recommendation for extended intervals between bone mineral density tests is reasonable for women who fit the rather restricted profile in the NEJM study, physicians should not apply these recommendations to all postmenopausal women. testing by DXA is the international standard for assessing skeletal health, the authors note, citing research from both the Geisinger Health System Osteoporosis Disease Management Program and Kaiser Permanente of Southern California, which found that increases in testing reduced fracture rates and associated .

"The JBMR has a responsibility to address important scientific and clinical issues regarding bone disease," concluded Dr. Thomas L. Clemens Editor-in-Chief of the JBMR. "As Dr. Lewiecki and colleagues point out, there are important limitations and exceptions to a recommendation of very long intervals between DXA testing"

add to favorites email to friend print save as pdf

Related Stories

Osteoporosis care at risk in the United States

Nov 12, 2008

The reimbursement cuts run contrary to existing federal initiatives already in place to increase fracture prevention efforts and improve the prevention, diagnosis and treatment of osteoporosis.

Healthy bones program reduces hip fractures by 37 percent

Nov 04, 2008

Proactive measures can reduce hip fracture rates by an average of 37.2 percent -- and as much as 50 percent -- among those at risk, according to a study conducted by Kaiser Permanente Southern California. The study was published ...

Recommended for you

Ebola isolation at US base 'pretty much vacation'

14 hours ago

With plenty of flat screen TVs, game nights and even an outdoor fire pit, life in isolation for members of the U.S. military who have returned from the Ebola mission in West Africa can look a lot like summer ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.