All women aged 65 years and older should be routinely screened for osteoporosis, as should younger women with increased risk factors for the disease if their 10-year fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors.
This new edict from the U.S. Preventive Services Task Force (USPSTF) represents the major change to its 2002 recommendations for osteoporosis screening. The USPSTF uses white women as the benchmark because of their markedly higher rater of osteoporosis and fractures compared with other groups. Tobacco use, alcohol use, low body mass, and parental history of fractures are additional risk factors for osteoporosis.
While the USPSTF put forth these recommendations regarding when to begin osteoporosis screening in women, the members set no end-date because fracture risk increases with age.
Although the USPSTF found “convincing” evidence that bone-measurement tests predict short-term risk for osteoporotic fractures in women and men, the task force found insufficient evidence to make a recommendation for screening men. The USPSTF acknowledges that the National Osteoporosis Foundation does recommend bone-density testing for all men aged 70 years and older.
In other osteoporosis-related developments:
- Australian researchers found that bisphosphonate treatment for osteoporosis appears to reduce mortality risk in women and possibly men, more so than hormone therapy or vitamin D with or without calcium, with gains of five extra years of life recorded (J Clin Endocrinol Metab. 2011 Feb 2 published online ahead of print).
- Although bisphosphonates are associated with a slightly elevated risk for osteonecrosis of the jaw, a large study suggests that the absolute risk remains low (J Dent Res. 2011 Feb 11 published online ahead of print).