New Bone Density Screening Guidelines

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The US Preventive Services Task Force (USPSTF) has issued new bone density screening guidelines that recommend some women as young as 50 should be checked for osteoporosis. It is the first time the USPSTF has also commented on whether men should be checked for their bone density status.

Osteoporosis is often viewed as a silent disease because most people do not know they have it until they experience a fracture. One way to detect bone thinning that can lead to osteoporosis is to undergo bone density screening. In 2002, the USPSTF provided guidelines that recommended screening for those most at risk for the disease, which included women older than 65, plus women age 60 to 64 at higher risk for fractures.

Osteoporosis is a major public health threat, affecting an estimated 44 million Americans, which is about 55 percent of people age 50 and older. According to the National Osteoporosis Foundation, 10 million Americans already have the disease, and an estimated 34 million have low bone density, which places them at increased risk for developing the disease.

Now the USPSTF is broadening its 2002 guidelines and recommending that younger postmenopausal women should be screened if their risk of a fracture is the same or greater than that of the average 65-year-old woman. Factors that can increase a woman’s risk include low body weight, use of certain drugs, smoking, heavy alcohol use, and a parent who has broken a hip.

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To arrive at their new drafted guidelines, the task force panel used a web-based risk calculator called FRAX, which estimate a person’s odds of experiencing a fracture within 10 years. The panel found that women as young as 50 may meet the threshold for bone density screening depending on their risk factors.

One thing the task force did not determine was how often women should have a repeat bone density screening, since it could not find enough evidence to make a recommendation. While it says a couple of years between screenings are needed, one large study conducted at the Oregon Evidence-based Practice Center at the Oregon Health and Science University in Portland found no advantage to repeat screening even after eight years.

Although the focus of concern for development of osteoporosis is on women, the government group also weighed whether men should be screened as well, but it decided “the evidence for primary prevention in men is lacking and future research is needed.” This is in contrast to the National Osteoporosis Foundation, which recommends screening men who are older than 70. The American College of Physicians states that doctors should check their older male patients for risk factors.

The new bone density screening guideline issued by the government-appointed task force panel is a draft and is open for public comment. The comment period opened on July 6, 2010, and closes on August 3, 2010 at 5:00 PM Eastern Time. Individuals who wish to comment can do so directly from the USPSTF website.

SOURCES:
National Osteoporosis Foundation
US Preventive Services Task Force

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