New Osteoporosis Screening Recommendations
MONDAY, Jan. 17 (HealthDay News) -- The U.S. Preventive Services
Task Force has just expanded its osteoporosis screening
recommendation to include younger women who have risk factors for
the debilitating disease, which causes bones to become abnormally
brittle and prone to fracture.
The newly released guidelines expand routine screening to
include all women 65 and older as well as younger women at
increased risk of bone fractures.
"This [new recommendation] extends it down to any postmenopausal-age woman whose risk is the same as a 65-year-old," said Dr. Ned Calonge, chair of the U.S. Preventive Services Task Force (USPSTF).
One example, he said, might be a postmenopausal woman not yet 65
who weighs under 125 pounds, smokes, drinks and has parents with a
history of bone fractures. All of those factors -- thin frame,
smoking, excess alcohol and family history -- boost the risk of
osteoporosis, he explained.
The new recommendations are published in the Jan. 18 issue of
Annals of Internal Medicine.
The USPSTF, which issues health-related recommendations after
reviewing the available medical evidence, is sponsored by the
federal Agency for Healthcare Research and Quality and composed of
an independent panel of experts in preventive and primary care.
The guidelines suggest that doctors and policymakers look at the
evidence underlying the task force recommendations, but also tailor
their decisions to the specific patient or situation.
Noting that the new recommendations update the USPSTF's 2002
guidelines, Calonge reported that in that year, "we had
insufficient evidence to suggest women under age 60 would benefit."
More current research, however, "suggests that treating those women
leads to reduced fractures," he said.
Osteoporosis screening "is a test that patients should be asking
about and clinicians should be providing," he said. The most
commonly used tests to screen for bone health are dual-energy x-ray
absorptiometry (DXA) of the hip and lumbar spine and quantitative
ultrasound of the heel, according to the USPSTF.
The task force also noted that therapies to prevent bone
fractures from osteoporosis included adequate calcium intake,
vitamin D intake, weight-bearing exercise and several approved drug
According to the new report by the panel, some 12 million
Americans over age 50 are expected to have osteoporosis by 2012.
Over half of all postmenopausal women will develop a fracture
related to osteoporosis during their lifetime, including 15 percent
who will suffer a hip fracture. Hip fractures, in particular, are
linked with chronic pain, disability, loss of independence and an
increased risk of death.
And these risks are not confined to women. Fewer men than women
develop osteoporosis, but more than one-third of men who sustain a
hip fracture die within a year.
Nonetheless, the USPSTF found insufficient evidence to recommend
screening for men, Calonge said. "That alerts the research world
[that] there is an important research gap," he said.
The new recommendations are now closer to those issued by other
groups, including the National Osteoporosis Foundation (NOF), said
Dr. Robert R. Recker, president of the foundation. The NOF now
recommends bone mineral density testing for women 65 and older, as
well as some younger postmenopausal women, based on their risk
factors, he said.
Unlike the task force, however, NOF also recommends testing for
all men 70 and older, and for men aged 50 to 69 with risk factors,
The recommendations issued by the task force do get the ear of
doctors in practice, Recker said. "A lot of primary care
practitioners have a list of these various recommendations by
USPSTF in their office and tend to refer to it."
Studies have shown that managing osteoporosis pays off by
reducing the fracture rate and overall costs, Recker said. One
study, for instance, found that good management of osteoporosis
cuts the hip fracture rate 25 to 50 percent.
To calculate your fracture risk, visit the
National Osteoporosis Foundation.
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