DXA Recommendations

Pam Flores @phflores Health Guide
  • At the first of the year we discussed the new recommendations for DXA scanning, which concluded that those over 65, with normal bone density scores may wait for their repeat scan for bone mineral density scores.  The study also mentioned that waiting fifteen years in-between scans would theoretically save our health care system billions of dollars.


    Since this recommendation was issued, there has been a lot of debate, including mine on this idea of saving money while cutting back on repeat scans.


    The original study was released by the New England Journal of Medicine (NEJM).   The following quote is from Medical News Today.

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    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.


    I wholeheartedly agree with this statement, and hope that physicians will do their due diligence by ordering DXA scans for those who have an osteopenia or osteoporosis diagnosis.  If at-risk patients put off testing, this underutilized screening will increase the cost of health care for patients who'll need bone loss and fracture treatment.  I do not believe that preventative screening will make health care costs skyrocket.  Since DXA scans are underutilized there is a large portion of society that may have bone loss and are either not treating it, or have no idea they have this.


    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. Bone mineral density 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 health care costs. 


    If you haven't had your bone mineral density tested, and you have two of the risk factors below, please talk to your physician about ordering this test now.


    The risk factors for osteoporosis are:



    We are told that osteoporosis is treatable and preventable, so these DXA tests are the only way we can truly find out if we need treatment earlier in life than we might have thought.  We don't want to hamper our ability to treat, prevent and maintain good bone health now.    


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Published On: March 11, 2012