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

March 1, 2012

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"

Related Stories

Recommended for you

Experimental MERS vaccine shows promise in animal studies

July 28, 2015

A two-step regimen of experimental vaccines against Middle East respiratory syndrome (MERS) prompted immune responses in mice and rhesus macaques, report National Institutes of Health scientists who designed the vaccines. ...

Can social isolation fuel epidemics?

July 21, 2015

Conventional wisdom has it that the more people stay within their own social groups and avoid others, the less likely it is small disease outbreaks turn into full-blown epidemics. But the conventional wisdom is wrong, according ...

Lack of knowledge on animal disease leaves humans at risk

July 20, 2015

Researchers from the University of Sydney have painted the most detailed picture to date of major infectious diseases shared between wildlife and livestock, and found a huge gap in knowledge about diseases which could spread ...

IBD genetically similar in Europeans and non-Europeans

July 20, 2015

The first genetic study of inflammatory bowel disease (IBD) to include individuals from diverse populations has shown that the regions of the genome underlying the disease are consistent around the world. This study, conducted ...

0 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.