The rise and rise of vitamin D testing

  • Bilinski K
  • Boyages S
  • 25

    Readers

    Mendeley users who have this article in their library.
  • 23

    Citations

    Citations of this article.

Abstract

Moynihan and colleagues' report highlights the increasing trend for overdiagnosis, particularly of endocrine disorders. 1 Similar concerns exist for overdiagnosis and overtreatment of vitamin D deficiency. 2 3 Currently, the appropriate timing and frequency of testing for the diagnosis of vitamin D deficiency is unclear. The cost of testing in Australia increased from $A1m (£0.66m; €0.83m; $1m) in 2000 to $95.6m in 2010, on average 59% each year. 2 Similarly, in Ontario, Canada, testing increased 25-fold from 2004 to 2010. Projections suggest that $C150m (£95m; €120m; $147m) will be spent on vitamin D testing in 2012, up from $38m in 2009. 4 Similarly, the UK has seen a sixfold increase in such tests between 2007 and 2010. 5 Our data show that the past 11 years have seen an unsustainable growth in vitamin D testing in Australia (figure⇓). These findings have widespread consequences in terms of quality of care, unnecessary cost, and potential overdiagnosis. Further studies are needed to determine whether this increased testing translates into improved vitamin D status in the population and subsequent health outcomes. Worryingly, however, this large increase in vitamin D testing did not translate into increased testing for osteoporosis, as shown by the flat trend in bone density measurements (figure⇓). Guidelines are urgently needed to limit overtesting, overdiagnosis, and as a consequence overtreatment for vitamin D deficiency. Competing interests: None declared. 1 Moynihan R, Doust J, Henry D. Preventing overdiagnosis: how to stop harming the healthy. BMJ 2012;344:e3502. (29 May.) 2 Bilinski KB, Boyages SC. The rising cost of vitamin D testing in Australia: time to establish guidelines for testing. Med J Aust 2012; published online 17 July. 3 Boyages SC, Bilinski K. Seasonal reduction in vitamin D level persists into spring in NSW Australia: implications for monitoring and replacement therapy. Clin Endocrinol 2012; published online 3 April. 4 Mittelstaedt M. Ontario considers curbing vitamin D testing. The Globe and Mail 2010. www.theglobeandmail.com/life/health-and-fitness/ontario-considers-curbing-vitamin-d-testing/article1380863/. 5 Sattar N, Welsh P, Panarelli M, Forouhi NG. Increasing requests for vitamin D measurement: costly, confusing, and without credibility. Lancet 2012;379:95-6. Cite this as: BMJ 2012;345:e4743

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document

Authors

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free