28 Jun USPSTF: Women 65 and Older Should Be Screened for Osteoporosis to Prevent Fractures
MedicalResearch.com Interview with:
Dr. Chien-Wen Tseng
Chien-Wen Tseng, M.D., M.P.H., M.S.E.E.
Hawaii Medical Service Association Endowed Chair in health services and quality research
Associate professor, and the Associate research director
Department of Family Medicine and Community Health
University of Hawaii John A. Burns School of Medicine
MedicalResearch.com: What is the background for this recommendation statement? What are the main findings and recommendations?
Response: Osteoporosis is a condition where bones become weak and can break or fracture more easily. These fractures can happen at the spine, hip, and other locations, and can have serious health consequences such as pain, limited mobility, or even death. By 2020, more than 12 million Americans over the age of 50 are expected to have osteoporosis and two million fractures occur yearly.
Since people often may not know they have osteoporosis until they have a fracture, the U.S. Preventive Services Task Force looked at the evidence to see if screening for osteoporosis can help to prevent fractures. We found that screening for and treating osteoporosis can prevent fractures in women ages 65 and older and in younger women who have been through menopause and have additional factors that put them at increased risk for osteoporosis.
In men, more research is needed to know if routine screening and treatment for osteoporosis can prevent fractures.
MedicalResearch.com: What should readers take away from your report?
Response: All women who are 65 and older should be screened for osteoporosis to prevent fractures. Women younger than 65 who have been through menopause should be screened if they have enough other factors that put them at increased risk, as determined by a formal clinical risk assessment tool. These tools take into account certain risk factors such as having a parent with a broken hip, smoking, heavy drinking, being on certain drugs long-term, or being underweight, among others. In men, we still need more quality research to understand whether treating osteoporosis for those without a history of fractures can help improve bone health. Most of the studies on drug treatment have been in post-menopausal women since these women are at highest risk for osteoporosis.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: In men, we need additional studies on whether general screening and treatment of osteoporosis will prevent fractures. For both women and men, we need to know if a screening test doesn’t show osteoporosis, whether re-screening should be done and, if so, how often. We also need to better understand if we can use an individual’s family and personal medical history to identify who is at high risk and make a decision to treat to prevent fractures, without first doing a bone measurement screening test. Additional studies are also needed to understand how to treat for osteoporosis.
MedicalResearch.com: Is there anything else you would like to add?
Response: Many of us know a family member, friend, or loved one who have experienced pain and loss of independence as a result of a fracture due to osteoporosis. With screening, we have the chance to find and treat osteoporosis early and prevent these fractures.
It is also important to note that this final recommendation statement applies only to older adults who do not have a history of prior fragility fractures or health conditions that could lead to weakened bones. Anyone who is concerned about their risk for osteoporosis or breaking a bone should talk to his or her doctor. The Task Force and other organizations also have recommendations on exercise and other ways people can reduce their risk for falls and fractures.
The Task Force has a short new video – check it out here.
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Last Updated on June 28, 2018 by Marie Benz MD FAAD