Updated guidelines urge routine bone density tests

More women should undergo routine bone density tests, according to updated U.S. Preventive Services Task Force recommendations for osteoporosis screening published online Jan. 17 in the Annals of Internal Medicine.

The revision expands recommended screening to women younger than 65 whose fracture risk is deemed equal to or greater than that of an average 65-year-old white woman, since white women are more prone to the disease than those of other ethnic groups. The task force has recommended routine screening for women 65 and older and high-risk patients 60 and older since 2002.

But research showed that there are some post-menopausal women younger than 60 at similar risk for osteoporosis as their older peers, said Ned Calonge, MD, MPH, task force chair and president and chief executive officer of the Colorado Trust, a foundation aimed at improving health care access in Colorado.

"That expansion is one thing we thought would be really important," said Dr. Calonge, a family and preventive medicine physician.

Ten million people in the U.S. have the disease, and 34 million more have low bone density, according to the National Osteoporosis Foundation.

A 65-year-old white woman with no other risk factors has a 9.3% risk of having an osteoporosis fracture within 10 years, the report said (link).

The new recommendation doesn't place an age limit on screening, since the risk of fractures increases with age. The task force also found insufficient evidence to make a recommendation regarding screening for men or the frequency of screening for women.

The recommendations were open for public comment from July 6 to Aug. 3, 2010. The task force received 55 comments from individuals, professional and advocacy organizations, and pharmaceutical and imaging companies.

The group is an independent panel of nonfederal medical experts in prevention and evidence-based medicine that reviews its standards at least every five years. Dr. Calonge said he hopes the new recommendations will be a strong reminder to patients and physicians about the importance of osteoporosis screening to prevent fractures.