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Women too often tested for osteoporosis, researchers report

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Published : Jan. 19, 2012 - 11:33

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Many women who get screened for osteoporosis may not need it, according to a study that suggests current guidelines result in too many unnecessary tests, increasing costs and sometimes spurring unnecessary treatment.

Osteoporosis, a loss in bone density that can cause breaks and injuries, develops in fewer than 10 percent of women at age 80, if they had normal density at age 65, according to a report today in the New England Journal of Medicine.

The U.S. Preventive Services Task Force, which sets testing guidelines, recommends a bone-density test every two years. The latest study suggests a healthy result at age 65 probably means woman can wait at least 15 years before being tested again because of how slowly the disease develops.

“There’s strong belief that the more we test, the more we are helping patients,” said Margaret Gourlay, a University of North Carolina at Chapel Hill researcher and study author. “This is a good example of why that doesn’t hold up at all.”

Osteoporosis affects about 12 million Americans older than 50, including half of all post-menopausal women at some point, the U.S. task force says. The recommendation for testing every two years was made because not enough is known about how the disease develops, the group has said.

Each screening costs about $250, Gourlay said in a telephone interview. Unnecessary tests can lead to false positives and prescriptions of drugs such as Warner Chilcott’s Actonel or Eli Lilly & Co. (LLY)’s Evista, leading to more patient risk than protection, she said.

Some doctors prescribe tests every two years because Medicare, the U.S. health plan for those 65 and older, reimburses for the exams on that schedule, Gourlay said. The research team tracked patients to gather available evidence to avoid health decisions made on “marketing, advocacy, and public beliefs that have encouraged overtesting and overtreatment,” the report said.

Just as a lack of information has caused some doctors to test too often, it has led others to ignore osteoporosis altogether, Gourlay said. Patients don’t remind doctors about osteoporosis screening, which is not as common as mammograms for breast cancer or cholesterol screening, she said.

The study followed about 5,000 mostly white women over 15 years and regularly tested their bone mass starting at age 67. Gourlay said the group’s next goals include gathering data about osteoporosis treatment in men and in women younger than 65.

 

<한글 기사>

"골다공증 검사, 자주할 필요 없다"

65세 이상 2년마다 불필요..골밀도 정상시 15년후 받아도 무방

여성들이 골다공증 검사를 2년마다 정기적으로 받을 필요가 없다는 연구결과가 나왔다.

미국 노스캐롤라이나대 연구진은 65세 때 측정한 골밀도가 정상치라면 이후 15년동안 골다공증이 일어날 확률이 10% 미만이라는 연구결과를 발표했다고 18일(현지시간) 블룸버그 통신이 전했다.

첫 측정에서 골밀도에 큰 문제가 없다면 15년 후에 두 번째 검사를 받아도 무방 하다는 것이다.

골다공증은 뼈의 강도가 약해져 골절이 일어날 가능성이 높은 상태로, 미국 예방진료 특별심의회는 65세 이상 여성에 2년마다 골다공증 검사를 받으라고 권장하고 있다.

그러나 연구진은 지난 15년동안 백인여성 5천여명을 대상으로 골밀도를 꾸준히 측정한 결과 기존에 알려진 것만큼 자주 검사를 받을 필요가 없다는 사실이 드러났다고 밝혔다.

연구진을 이끈 마거릿 고울레이 박사는 골다공증 검사 한 번에 250달러(약 28만 원)가 들지만 "검사를 많이 할수록 환자를 돕는 것이라는 강한 믿음이 의사들 사이에 퍼져 있다"고 말했다.

고울레이 박사는 미국 의료보험제도가 2년에 한 번씩 골밀도 검사비를 지원하기 때문에 많은 의사가 이 주기에 맞춰 골밀도 검사를 받게 한다고 지적했다.

그는 이러한 검사 때문에 악토넬정(Actonel), 에비스타(Evista) 같은 골다공증 치료용 약물이 불필요하게 처방된다고 덧붙였다. 

이 연구결과는 의학 연구분야 권위지인 NEJM(New England Journal of Medicine) 최신호에 실렸다.