Common Questions
Is routine screening for osteoporosis recommended for all women?
It is widely recommended (see organizations below) that all postmenopausal women 65 or older be screened for osteoporosis (1-4). There is no direct evidence that screening prevents fracture. However, since prevalence of osteoporosis and fracture increase with age, screening is supported by indirect evidence that short-term outcomes, particularly for hip fracture, may be improved with appropriate screening and treatment. The figure below demonstrates how the number needed to screen to prevent one hip fracture dramatically drops with age.
Figure 1: Number needed to screen to prevent one hip fracture in five years. The dotted line indicates women with at least on risk factor; the solid line indicates women without risk factors.
National organizations recommending screening at age 65:
- National Osteoporosis Foundation
- U.S. Preventive Services Task Force
- American Association of Clinical Endocrinologists
- North American Menopause Society
- Screening for Postmenopausal Osteoporosis: A Review of the Evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine 2002; 529-41.
- National Institutes of Health Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. JAMA 2001; 285: 785-795.
- Hodgson SF, Watts NB, Bilezikian JP, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003. Endocr Pract 2003; 9: 544-564.
- Management of postmenopausal osteoporosis: position statement of The North American Menopause Society. Menopause 2002; 9: 84-101.