USPSTF Issues Draft Recommendation on Vitamin D Screening in Adults

September 23, 2020

The US Preventive Services Task Force concluded that the current evidence is insufficient to make a recommendation for or against vitamin D deficiency screening in asymptomatic adults.

The US Preventive Services Task Force (USPSTF) determined that there is not enough evidence to recommend for or against screening for vitamin D deficiency in asymptomatic adults, according to a draft recommendation statement.1

However, the statement noted the recommendation does not apply to those who already have health conditions where vitamin D supplementation is required.1

Vitamin D is a vital nutrient for bone health and may play a role in other aspects of health as well. Individuals typically receive vitamin D through certain foods, supplements, and sun exposure. However, some individuals experience low levels of vitamin D, which can affect their health. Vitamin D deficiency is usually treated with oral vitamin D, which is available both as a prescription or OTC dietary supplement. According to the National Academy of Medicine, 97.5% of the population will have their vitamin D needs met at a serum level of 20 ng/mL and that risk for deficiency, relative to bone health, begins to occur at levels less than 12 to 20 ng/mL.1

Based on the task force’s review, USPSTF concluded that more research is needed to make a recommendation for or against screening adults for vitamin D deficiency without signs or symptoms. Since ideal vitamin D levels can vary from person to person, more information is needed to develop a consensus regarding the precise levels of vitamin D required for optimal health.1

“We don’t the precise level of vitamin D in the body that leads to poor health outcomes, or which test might be a better indicator of vitamin D deficiency,” said Task Force member John Wong, MD, in the statement.2 “Once we now the level of vitamin D that people need to remain healthy, or if there is a better test, more research on whether screening can help prevent negative outcomes, such as falls, cancer, or health problems will be helpful.”

Moreover, more research is needed to determine the cut point that defines vitamin D deficiency, and whether that measure varies by subgroups, according to USPSTF. Without a consensus, general screening could potentially misclassify individuals with a vitamin D deficiency and lead to overdiagnosis or underdiagnosis.1

When final, this recommendation will replace the 2014 USPSTF recommendation statement, which also concluded that evidence was insufficient to assess the balance of benefits and harms of screening vitamin D deficiency in asymptomatic adults.1

References

1. Vitamin D Deficiency in Adults: Screening. Draft recommendation statement. US Preventive Services Task Force; September 22, 2020. Accessed September 23, 2020. https://uspreventiveservicestaskforce.org/uspstf/draft-recommendation/vitamin-d-deficiency-screening-2021#fullrecommendationstart

2. Task Force Issues Draft Recommendation Statement on Screening for Vitamin D Deficiency in Adults. News release. US Preventive Services Task Force; September 22, 2020. Accessed September 23, 2020. https://uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/vitamin-d-deficiency-screening-draft-rec-bulletin.pdf