Comments in Favor of Draft Recommendation on Screening for Vitamin D Deficiency

Comments of Members of the Patient, Consumer, and Public Health Coalition
on
U.S. Preventive Services Task Force (USPSTF)
Draft Recommendation Statement on Screening for Vitamin D Deficiency

Members of the Patient, Consumer, and Public Health Coalition commend the U.S. Preventive Services Task Force (USPSTF) efforts to provide advice based on scientific evidence on screening for vitamin D deficiency in the general adult population.

We acknowledge the importance of vitamin D in promoting calcium absorption and for healthy bone growth. There has been growing interest in learning how vitamin D can affect various chronic diseases, such as cardiovascular disease[1] and diabetes,[2] and whether screening for vitamin D deficiency can actually improve health.  However, we agree with the conclusions drawn by the USPSTF: There is insufficient evidence to propose recommendations for or against screening for vitamin D deficiency in adults who do not present with symptoms associated with such deficiency.

Most important, there is no universally acknowledged definition or assessment of vitamin D deficiency.[3] In fact, although the Institute of Medicine has recommendations for dietary allowances for vitamin D, it does not provide any guidelines for vitamin D deficiency screening. With no standard measurement for vitamin D deficiency, it is difficult to know how effective and accurate the current testing methods are. Until more research is done to develop a universal threshold that clearly defines what vitamin D deficiency is, we agree that it makes no sense to recommend for or against screening.

We are concerned that without a clear consensus on how to define vitamin D deficiency, screening could lead to misclassification, overdiagnosis, underdiagnosis, or unnecessary use of the available screening tools.  Any of these outcomes could do more harm than good.

We strongly commend the USPSTF for placing the public’s health at the forefront and weighing the evidence in an objective manner. The public, particularly those who do not show any symptoms of vitamin deficiency, should not be exposed to screenings where the risks and benefits are still unknown.  Members of the Patient, Consumer, and Public Health Coalition applaud the U.S. Preventive Services Task Force (USPSTF) efforts to provide advice based on scientific evidence on screening for vitamin D deficiency in the general adult population.

American Medical Women’s Association
National Center for Health Research
National Consumers League
National Organization for Women
National Women’s Health Network
Our Bodies Ourselves
WoodyMatters

The Patient, Consumer, and Public Health Coalition can be reached through Paul Brown at (202)223-4000 or at pb@center4research.org.

 

 

 


[1] Wang TJ, Pencina MJ, Booth SL, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008; 117:503-11.

[2] Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care. 2006;29:650-6.

[3] Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Osteoporos Int. 2005;16:713-6.