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Clinical Summary

Osteoporosis: Screening

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Clinical Summary of U.S. Preventive Services Task Force Recommendation

This document is a summary of the 2011 recommendation of the U.S. Preventive Services Task Force on screening for osteoporosis. It is intended for use by primary care clinicians. This summary was first published inAnnals of Internal Medicine on January 18, 2011. (Ann Intern Med 2011 Jan 18. [Epub ahead of print])


Population Women age ≥65 years without previous known fractures or secondary causes of osteoporosis Women age <65 years whose 10-year fracture risk is equal to or greater than that of a 65-year-old white woman without additional risk factors Men without previous known fractures or secondary causes of osteoporosis
Recommendation Screen No recommendation
Grade: B Grade: I
(insufficient evidence)
Risk Assessment As many as 1 in 2 postmenopausal women and 1 in 5 older men are at risk for an osteoporosis-related fracture. Osteoporosis is common in all racial groups but is most common in white persons. Rates of osteoporosis increase with age. Elderly people are particularly susceptible to fractures. According to the FRAX fracture risk assessment tool, available at http://www.shef.ac.uk/FRAX/, the 10-year fracture risk in a 65-year-old white woman without additional risk factors is 9.3%.
Screening Tests Current diagnostic and treatment criteria rely on dual-energy x-ray absorptiometry of the hip and lumbar spine.
Timing of Screening Evidence is lacking about optimal intervals for repeated screening.
Intervention In addition to adequate calcium and vitamin D intake and weight-bearing exercise, multiple U.S. Food and Drug Administration–approved therapies reduce fracture risk in women with low bone mineral density and no previous fractures, including bisphosphonates, parathyroid hormone, raloxifene, and estrogen. The choice of treatment should take into account the patient's clinical situation and the tradeoff between benefits and harms. Clinicians should provide education about how to minimize drug side effects.
Suggestions for Practice Regarding the I Statement for Men

Clinicians should consider:

  • potential preventable burden: increasing because of the aging of the U.S. population
  • potential harms: likely to be small, mostly opportunity costs
  • current practice: routine screening of men not widespread
  • costs: additional scanners required to screen sizeable populations

Men most likely to benefit from screening have a 10-year risk for osteoporotic fracture equal to or greater than that of a 65-year-old white woman without risk factors. However, current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis in men.

For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.

Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Copyright and Source Information

This document is in the public domain within the United States.

Current as of: January 2011

Internet Citation: Clinical Summary: Osteoporosis: Screening. U.S. Preventive Services Task Force. October 2014.
https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/osteoporosis-screening

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