| VOLUME 33, NUMBER 29 | THURSDAY, June 27, 2002 |
Osteoporosis undertreated By
LOIS BAKER Osteoporosis,
a disease of bone-thinning that puts women at risk of serious fractures,
is underdiagnosed and undertreated, according to a study by UB researchers
presented last week at the annual meeting of the Society for Epidemiological
Research in Palm Desert, Calif.
Nearly
half of 836 women in a population-based study who underwent screening
for osteoporosis for the first-time were found to have undiagnosed disease,
results showed. Moreover, follow-up a year later revealed that half
of those diagnosed with osteoporosis did not begin treatment to slow
progression of the disorder and a quarter failed to discuss the screening
results with their physician.
"This
study tells us there are a lot of women with osteoporosis who don't
know it," said Jean Wactawski-Wende, assistant professor of social and
preventive medicine and obstetrics and gynecology, and senior researcher
on the study.
"Many
women who are at risk for osteoporosis are not being referred for screening,
and even when screened, only half of those found to have osteoporosis
end up receiving therapy," she said. "We have a long way to go in educating
women and their physicians about osteoporosis."
The
results were presented in a poster session at the meeting.
Osteoporosis
is a serious health condition, associated primarily with aging, in which
bones lose mass and become brittle, breaking easily. Eight million women
and 2 million men in the U.S. are estimated to have osteoporosis, and
an estimated 34 million more people have low bone density, according
to the National Osteoporosis Foundation (NOF).
The
best method to determine if a person has osteoporosis is a dual-energy
x-ray absorptiometry (DXA) scan, which can assesses the bone-mineral
density at any particular site in the body and compute a comparison
with the established optimum density for that site.
The
current research—an ancillary study of the Women's Health Initiative,
for which UB is a vanguard clinical center—was designed to find
out what factors would influence a woman's decision to begin therapy
after being diagnosed with osteoporosis through DXA screening. The study
group was composed of 836 Caucasian women between the ages of 58 and
90 in Western New York who were being assessed for the association between
osteoporosis and periodontal disease. None of the women had been diagnosed
previously with osteoporosis or had undergone bone-density testing.
Of
the total screened, 428 were found to have bone density at least two
standard deviations below the norm, the definition of osteoporosis adopted
by the NOF in a general population at normal risk. All participants
received an explanation of the screening results and instructions to
discuss the results with their physician. They were recontacted by mail
after one year to find out how many had begun treatment. (Five drugs
for osteoporosis have been approved by the Food and Drug Administration;
all work by helping to stop the resorption of bone minerals by other
cells in the body.)
Results
showed that 307 of those diagnosed with osteoporosis had discussed the
results with their physician, as instructed. Of those who did talk to
their doctors about their condition, only 167 of osteoporotic women,
or about 54 percent, began treatment.
When
factors that might influence therapy were analyzed singly, results showed
that women who began treatment were more likely to have lower bone-mineral
density scores, indicating the condition was at a more advanced stage;
visit the doctor more then once a year, and be thinner and better educated
than those who didn't begin treatment.
When
all factors were analyzed together, the variables most strongly associated
with treatment were low bone density and higher education, Wactawski-Wende
said.
Part
of this on-going research project will be to determine the most effective
ways to educate both doctors and the community about the importance
of routine bone-density screening and of taking appropriate medications
and preventive measures to slow the process if osteoporosis is diagnosed.
Study finds many women unaware of bone-thinning disease
Contributing Editor