Osteoporosis Screening
Urged for Older Women
Excerpt By Charnicia E. Huggins, Reuter's Health

NEW YORK (Reuters Health) - Women aged 65 and older should be routinely screened for osteoporosis, according to new recommendations by the US Preventive Services Task Force.

Sixty-year-old women who are at risk of bone fractures should also be screened for the degenerative bone disease, medical experts advise in the September 17th issue of Annals of Internal Medicine.

"If you're 60 or older, talk with your clinician about screening," Dr. Alfred Berg, chair of the task force, told Reuters Health.

He explained that although some doctors have been screening women for osteoporosis for years, the task force previously reported in 1996 that there was insufficient evidence to recommend such screenings.

Since then, however, the task force has gathered new evidence that suggests a woman's risk of osteoporosis increases with increasing age, and that bone density tests can determine her risk of fractures in the short term. Further, elderly women who do not have any symptoms of the bone condition can receive treatment to reduce their fracture risk, the report indicates.

There seems to be "a pretty good linking between screening, treatment and preventing fractures," Berg said.

Currently, the most commonly prescribed method for treating osteoporosis and preventing fractures is for women to increase their calcium intake, either via calcium supplements or by eating more dairy-rich foods, according to Berg. Other treatment options include hormone replacement therapy and treatment with a class of drugs known as bisphosphonates.

"Clinicians should review with patients the relative benefits and harms of available treatment options, and uncertainties about their efficacy and safety, to facilitate an informed choice," the report states.

Women who weigh less than 70 kilograms (154 pounds) and are not using hormone replacement therapy have the highest risk of both osteoporosis and fracture, the report indicates. Also, white women, who tend to have a lower bone mineral density than their African-American peers, may be more likely to benefit from the screening.

Still, despite the current screening recommendations, it is not known how often women should undergo osteoporosis screenings, or up to what age the screenings remain effective, Berg said. And the benefits and risks of screening in women younger than 60 years or in women aged 60 to 64 who are not at risk of fracture have not yet been determined.

Osteoporosis currently affects an estimated 10 million Americans, including 8 million women, and causes 1.5 million fractures annually, according to the National Osteoporosis Foundation.

SOURCE: Annals of Internal Medicine 2002;137.

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