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In a significant update to its guidelines, the U.S. Preventive Services Task Force (USPSTF) has issued a new recommendation for osteoporosis screening aimed at preventing osteoporotic fractures in women aged 65 years and older. The recommendation, published online on January 14 in the Journal of the American Medical Association, also includes postmenopausal women under the age of 65 who are at increased risk.
The updated guidelines emphasize that osteoporosis screening for women in these categories provides substantial benefits, particularly in reducing the risk of hip and major osteoporotic fractures. The recommendation stems from a comprehensive review of evidence conducted by Dr. Leila C. Kahwati, M.D., M.P.H., and colleagues from the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center. Their analysis included three randomized clinical trials and three systematic reviews, all of which supported the positive outcomes associated with screening in older, high-risk women.
The study found that screening led to a significant reduction in fractures. Specifically, compared with usual care, screening resulted in a 17% reduction in hip fractures and a 6% reduction in major osteoporotic fractures. On a larger scale, for every 1,000 participants screened, five to six fewer fractures occurred. These findings provide moderate evidence of the benefit of osteoporosis screening in women aged 65 and older and postmenopausal women at increased risk.
As a result of these findings, the USPSTF has issued a “B” recommendation for osteoporosis screening in these groups, indicating a moderate net benefit in preventing fractures. The task force concluded that the evidence is sufficiently robust to support screening for women in these age groups.
However, the recommendation for men remains inconclusive. The evidence on osteoporosis screening in men is insufficient, and the USPSTF was unable to determine whether screening for osteoporotic fractures would offer a net benefit for men. In response, Dr. John Wong, M.D., vice chair of the task force, emphasized the need for more research in men and encouraged individuals to discuss bone health concerns with their healthcare providers.
This new recommendation is part of ongoing efforts to reduce the impact of osteoporosis, a condition that significantly increases the risk of fractures and other complications. Osteoporotic fractures, particularly in the hip and spine, can lead to long-term disability and decreased quality of life. Early detection through screening is seen as a crucial step in addressing the condition before fractures occur.
For more detailed information, the full recommendation statement and supporting evidence report are available through the Journal of the American Medical Association.
References:
- USPSTF Final Recommendation Statement
- Journal of the American Medical Association, January 14, 2025
