Osteoporosis often undiagnosed, untreated in US

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Osteoporosis often undiagnosed, untreated in US

By Mulvihill

NEW YORK, Feb 01 (Reuters Health) - Only about one third of US women

diagnosed with osteoporosis during the 1990s were offered treatment for

the bone-thinning condition, study findings indicate.

And among women aged 60 and older--20% to 30% of whom are estimated to

have osteoporosis--the study found only 2% had actually been diagnosed

with the condition.

Osteoporosis develops when the body breaks down bone faster than it

rebuilds it. The disease can lead to painful and debilitating bone

fractures, particularly in the hips, wrists and spine. Osteoporosis can

be treated with drugs that block the reabsorption of bone. Calcium and

vitamin D can also help maintain and rebuild bone strength.

To investigate how frequently osteoporosis is recognized and treated

among older women, Dr. H. Gehlbach and colleagues from the

University of Massachusetts at Amherst reviewed 1993 to 1997 data from

the National Ambulatory Medical Care Survey. These surveys sample visits

made to doctors' offices throughout the US during a 1-week period, and

include thousands of patient records.

From 1993 to 1997, fewer than 2% of women aged 60 and older were

diagnosed with osteoporosis, the researchers found. But the rate did

increase from 1.2% in 1993 to 2.7% in 1997, they report in the February

issue of the American Journal of Public Health, journal of the American

Public Health Association.

Overall, 36% of women diagnosed with osteoporosis were prescribed

calcium, vitamin D or drugs to treat the disease, the report indicates.

But this also increased, from 20% in 1993 to 55% in 1997.

Gehlbach told Reuters Health during an interview that the exact reason

for the low diagnosis and treatment rates is a mystery. " I don't really

have an explanation, " he said.

But the fact that osteoporosis is a " silent " condition, meaning it is

difficult to diagnose in the absence of symptoms like bone fracture,

could be a contributing factor, Gehlbach noted. " Even when fractures are

present, they often do not produce symptoms or precipitate visits to

physician offices, " he and his colleagues write.

Experts urge women to have their bone mineral density (BMD) evaluated,

as this is the best method for determining whether a person has

osteoporosis or is at risk of developing it. BMD testing is a quick,

non-invasive and accurate method for assessing future fracture risk,

Gehlbach pointed out.

" The findings of this study are very consistent with many other studies

out there, " Dr. Felicia Cosman, clinical director of the National

Osteoporosis Foundation, told Reuters Health in a telephone interview.

" The vast majority of women do not know that they have this illness,

have never been offered a bone mineral density test and have never been

treated, " she added. " Bone mineral testing should be as routine as

mammography screening for breast cancer or the PSA test for prostate

cancer. "

The foundation's guidelines recommend BMD testing for all women older

than 65 and younger postmenopausal women who may be at risk.

Osteoporosis currently affects more than 23 million American women, and

causes 1.5 million fractures each year. Nearly half of all women over

the age of 50 will be affected by osteoporosis at some point in their

lives.

Procter and Gamble Pharmaceuticals, which makes the anti-osteoporosis

drug Actonel, funded the study.

SOURCE: American Journal of Public Health 2002;92:271-273.