The National Osteoporosis Foundation Responds to Choosing Wisely™ Campaign Recommendations

WASHINGTON, April 5, 2012 /PRNewswire/ -- The National Osteoporosis Foundation (NOF) agrees with the recommendation released today as part of the Choosing Wisely™ campaign that women under age 65 and men under age 70 should not be screened for osteoporosis with dual energy X-ray absorptiometry (DXA). But the nation's leading community health organization dedicated to preventing osteoporosis and broken bones cautions patients to consult with their physicians about their risk factors before deciding to forgo the test. Also consistent with the American Board of Internal Medicine Foundation's (ABIMF) recommendations, NOF recommends testing post-menopausal women under age 65 and men age 50-70 who have osteoporosis risk factors.

While NOF agrees with the ABIMF on both points, the organization points out that there are a host of conditions that can increase fracture risk in younger individuals, which means that physicians need to carefully examine their younger patients' medical history and conduct a physical examination to thoroughly assess their risk factors for osteoporosis. As physicians are increasingly pressed for time, DXAs are often ordered to rule out the diagnosis of osteoporosis when risk factors are present in younger individuals.

The Choosing Wisely recommendations also overlook a key fact that DXA remains widely underutilized by women age 65 and older – the population at greatest risk for osteoporosis and fractures. In fact, only 13 percent of women age 65 and older have ever received a DXA test, according to a study published in the December 2011 issue of Health Affairs.

"We know that in the U.S. today, one in two women and one in four men age 50 and older will break a bone due to osteoporosis," said Robert Recker, M.D., president of the National Osteoporosis Foundation.  "But we also know that DXA testing is effective in reducing fractures among elderly women, the group at highest risk, by up to 20 percent."

Osteoporosis currently causes an estimated two million fractures each year and often results in immobility, pain, placement in a nursing home, isolation and other health problems—conditions and circumstances that could largely be prevented through proper bone density testing and diagnosis. So while DXA may be over utilized in younger individuals, this inexpensive test, which costs Medicare $56, remains dramatically underutilized among the group at highest risk for fracture.

While the recommendations of the ABIMF may be used as a guide for patients to ask their physicians which medical tests are right for their needs, NOF wants to make it clear that the appropriate use of DXA and available therapeutic agents can greatly reduce the burden of osteoporosis.

About the National Osteoporosis Foundation 
Established in 1984, the National Osteoporosis Foundation, a leading community-focused health organization, is dedicated to the prevention of osteoporosis and broken bones, the promotion of strong bones for life and the reduction of human suffering through programs of awareness, education, advocacy and research. For more information on the National Osteoporosis Foundation, visit www.nof.org.

SOURCE National Osteoporosis Foundation

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