USPSTF - No Need to Screen for Vitamin D Deficiency Save

JAMA has published the new recommendation from the US Preventive Services Task Force (USPSTF) stating that screening for vitamin D deficiency is unnecessary and unwarranted in asymptomatic adults.

Vitamin D plays an important role in calcium and bone metabolism, immune and other cellular regulatory functions outside the musculoskeletal system. Vitamin D deficiency is common, its clinical associations are numerous and suspect. Moreover, no one serum vitamin D level cutpoint defines deficiency, and there is no clear consensus on what defines optimum vitamin D levels for optimal health. One study reported a more than 80-fold increase in Medicare reimbursement volumes for vitamin D testing from 2000 to 2010.

The USPSTF commissioned a systematic review on vitamin D screening for deficiency, including the benefits and harms of screening and early treatment. They concluded that community-dwelling, nonpregnant adults who have no signs or symptoms of vitamin D deficiency or conditions for which vitamin D treatment is recommended will not benefit from screening for vitamin D deficiency. 

Widespread screening may misclassify persons with a vitamin D deficiency, resulting in overdiagnosis or underdiagnosis.  There is a rare potential harm to vitamin D overtreatment that may results in hypercalcemia, hyperphosphatemia and hypercalciuria. Nonetheless, usual oral vitamin D supplements are not associated with serious harms.