Women may get unneeded osteoporosis screening
Aug 29, 2011, 10:24 a.m.
They are also similar to recommendations issued earlier this year by the U.S. Preventive Services Task Force (USPSTF), an expert panel supported by the federal government.
The panel said that for women ages 50 to 64, doctors should consider risk factors like smoking, drinking and low body weight, and then estimate a woman's risk of having a bone fracture in the next 10 years. If she has the same risk as the average 65-year-old woman would -- a roughly nine percent chance over 10 years -- then screening would make sense.
According to Schnatz, the bottom line for women is to be aware of the screening guidelines, and if a doctor does recommend DXA testing, don't be afraid to ask questions.
"Make sure you understand why screening is being recommended," he said.
But while the current findings suggest that some women have osteoporosis screening when they don't need it, they also point to a problem of under-treatment.
That is, among women who were screened and met NAMS guidelines for osteoporosis treatment, 35 percent were not on any type of therapy. And more than half -- 53 percent -- were not getting regular exercise, which is recommended for protecting bone mass.
Again, Schnatz said, the reasons for the finding are unclear. The researchers don't know, for example, how often women were offered treatment, but declined.
It would be helpful, Schnatz said, for future studies to try to weed out the reasons why some women are screened when they don't meet guidelines -- and why others are not treated even though they do.
Larger studies of more diverse groups of women would also be useful, he said. A limitation of the current study is that all of the women were from a single U.S. city, so it's not clear whether the results would be the same nationwide.
It's estimated that about 12 million Americans older than 50 have osteoporosis, and roughly half of postmenopausal women will suffer an osteoporosis-related fracture at some point.
Indeed, another recent study found a rise in fracture risk in older women after they go off hormone replacement therapy. (See Reuters Health story of August 29, 2011).
To help prevent bone loss with age, experts recommend getting a well-balanced diet with enough calcium and vitamin D, in particular, as well as regular exercise.
SOURCE: http://bit.ly/nXNBWh Menopause, online July 8, 2011.