Iron Deficiency Screening: Cost-Effective and Beneficial for Women
Should All Women Be Screened for Iron Deficiency?
New research raises questions about the cost-effectiveness of routine screening for iron deficiency in women of reproductive age, a condition that can lead to fatigue, brain fog, and hair loss.
While iron deficiency is common, affecting millions of American women, there’s currently no recommended screening protocol. “We currently do not screen women at all,” says Ariela Marshall, MD, a hematologist and associate professor of medicine at the University of Minnesota in Minneapolis. “There is no recommended screening for iron deficiency for women, or for anyone, the way we recommend screening for cervical cancer or breast cancer.”
A new study presented at the annual meeting of the American Society of Hematology aimed to shed light on the cost-effectiveness of screening. Researchers compared the costs and benefits of three approaches: no screening, screening and diagnosing iron deficiency at a ferritin level of 25 micrograms per liter (ug/L), and screening at a lower ferritin level of 15 ug/L.
Weighing the Costs and Benefits
The study, which has not yet been published in a medical journal, used quality-adjusted life years (QALY) to assess the impact of screening and treatment on both life expectancy and daily life. Researchers factored in the costs of both oral iron supplements and intravenous iron infusions.
Surprisingly, the study found no important difference in cost-effectiveness between screening and not screening for iron deficiency, regardless of the ferritin level used for diagnosis or the type of iron supplementation.
The challenge of Underdiagnosis
Despite the findings, experts emphasize the importance of recognizing and addressing iron deficiency. “The issue is that there are many symptoms and many of them can be seen outside of iron deficiency,” says George Goshua, MD, a hematologist-oncologist and assistant professor at Yale Cancer Center and Yale School of Medicine.
These symptoms, which can include restless legs, cravings for ice, cognitive fog, shortness of breath, and fatigue, often overlap with other conditions, making it difficult for women to know when to seek testing.
Leo Buckley, PharmD, MPH, a clinical pharmacy specialist at Brigham and Women’s Hospital in Boston, points out that while the study raises significant questions about universal screening, many women likely remain undiagnosed. “The question then becomes what are the pros and cons of screening all women for iron deficiency,” he says.
Symptom-Based Screening: A Practical Approach
While the debate on universal screening continues, experts agree that women experiencing symptoms suggestive of iron deficiency should be tested. “If women have symptoms and are then tested for iron deficiency,they do experience benefit,” says Sant-Rayn Pasricha,MBBS,PhD,acting director of the anemia lab at Walter and Eliza Hall Institute of Medical Research in Melbourne,Australia.
Iron supplements can effectively alleviate symptoms in women diagnosed with iron deficiency.
Ultimately, the decision of whether or not to screen for iron deficiency should be made on an individual basis, taking into account a woman’s symptoms, medical history, and risk factors.
Should All Women Be Screened for Iron Deficiency?
New research is raising questions about the cost-effectiveness of routine iron deficiency screening in women of reproductive age. While iron deficiency is common, affecting millions of American women, there’s currently no recommended screening protocol.
“We currently do not screen women at all,” says Ariela Marshall, MD, a hematologist and associate professor of medicine at the University of Minnesota in Minneapolis. “There is no recommended screening for iron deficiency for women, or for anyone, the way we recommend screening for cervical cancer or breast cancer.”
A new study presented at the annual meeting of the american Society of hematology aimed to shed light on the cost-effectiveness of screening.Researchers compared three approaches: no screening, screening and diagnosing iron deficiency at a ferritin level of 25 micrograms per liter (ug/L), and screening at a lower ferritin level of 15 ug/L.
The study, which has not yet been published in a medical journal, used quality-adjusted life years (QALY) to assess the impact of screening and treatment on both life expectancy and daily life. Researchers factored in the costs of both oral iron supplements and intravenous iron infusions.
Surprisingly, the study found no vital difference in cost-effectiveness between screening and not screening for iron deficiency, irrespective of the ferritin level used for diagnosis or the type of iron supplementation.
Despite the findings, experts emphasize the importance of recognizing and addressing iron deficiency. “The issue is that there are many symptoms and many of them can be seen outside of iron deficiency,” says George Goshua, MD, a hematologist-oncologist and assistant professor at Yale Cancer Center and Yale School of medicine.
these symptoms, which can include restless legs, cravings for ice, cognitive fog, shortness of breath, and fatigue, frequently enough overlap with other conditions, making it tough for women to know when to seek testing.
Leo Buckley, PharmD, MPH, a clinical pharmacy specialist at Brigham and Women’s Hospital in Boston, points out that while the study raises important questions about universal screening, many women likely remain undiagnosed.”The question than becomes what are the pros and cons of screening all women for iron deficiency,” he says.
While the debate on universal screening continues, experts agree that women experiencing symptoms suggestive of iron deficiency should be tested.”If women have symptoms and are then tested for iron deficiency, they do experience benefit,” says Sant-Rayn Pasricha, MBBS,PhD, acting director of the anemia lab at Walter and Eliza Hall Institute of Medical Research in Melbourne, Australia.
Iron supplements can effectively alleviate symptoms in women diagnosed with iron deficiency. Ultimately, the decision of whether or not to screen for iron deficiency should be made on an individual basis, taking into account a woman’s symptoms, medical history, and risk factors.