Surgeon General Report Calls for Increased Efforts To Prevent, Treat Osteoporosis

About 34 million U.S. residents are at risk of developing the bone-weakening disease osteoporosis, and more people will continue to be at risk for the disease as the population ages, according to a surgeon general's report released Thursday, the Baltimore Sun reports.

The two-and-a-half-year report, which does not present any new research, is the first from the surgeon general to focus on bone health. The 400-page report, written by more than 100 experts, compiles recent research and medical advances on osteoporosis, which affects 10 million U.S. residents, and made recommendations for improving prevention and treatment.

According to the report, by 2020, half of U.S. residents over age 50 will have developed or be at risk for osteoporosis. The report estimates that the current cost for treating the disease, which contributes to about 1.5 million fractures annually, is about $14 billion (Kohn, Baltimore Sun, 10/15).

The report, which cost $1.3 million to produce, recommended bone density testing for women over age 65, who are most at risk for developing the disease, and for patients who break a bone after age 50. People should also work with their doctor to determine if they should be tested, the report says.

The report also recommends several preventive measures for people of all ages to help maintain bone mass, including eating more leafy green vegetables, dairy products and other foods or drinks containing high levels of calcium and vitamin D; maintaining a healthy weight; exercising often; avoiding drinking alcohol and smoking.

The report also notes other risk factors for osteoporosis, such as early onset of menopause and taking steroids, chemotherapy drugs and certain other medications (Reuters/New York Times, 10/15).

According to the report, there have been significant advances in prevention and treatment research for osteoporosis, but health care professionals "often fail to diagnose and treat" the disease, the Los Angeles Times reports (Schwartz, Los Angeles Times, 10/15).

The report states that osteoporosis is "underdiagnosed because many people don't know their bones are thinning until one breaks," and doctors sometimes "even forge[t] to check bone density when middle-aged or older patients suffer fractures," the AP/Albany Times Union reports.

According to the study, fewer than 25% of hip-fracture patients receive calcium, vitamin D supplements or a bone-density test (Neergaard, AP/Albany Times Union, 10/15).

Redonda Miller, an internist and osteoporosis specialist at Johns Hopkins Hospital, said that more than two-thirds of women with the disease have not been diagnosed yet. Miller added, "Because we're living longer, this is becoming a bigger problem. ... It has not been a priority for the health care system, and it should be." Deborah Gold of Duke University, one of the report's authors, said doctors "assume it's part of aging. It isn't. It's a disease."

"This report is a milestone in the field of osteoporosis and bone health," Bess Dawson-Hughes, president of the National Osteoporosis Foundation, said.

Surgeon General Richard Carmona said, "We have a problem with bone health in the United States, and much of it is preventable." Carmona emphasized that although osteoporosis treatments have advanced in recent years, people should focus on prevention starting at a young age (Baltimore Sun, 10/15). "What we really want to do is make it so that we reduce the dependence on medications, on very costly therapy," Carmona said (Reuters/New York Times, 10/15).

He added, "Thirty years ago, when I was a medical student, we thought osteoporosis was a natural part of aging. But today we know there is a lot we can do to prevent it" (Los Angeles Times, 10/15).