Authors' objectives:

To examine evidence on the benefits and harms of screening asymptomatic postmenopausal women for osteoporosis.

Authors' results and conclusions: Although many studies have been published about osteoporosis in postmenopausal women, there have been no trials of screening and, therefore, no direct evidence that screening improves outcomes. Instruments developed to assess clinical risk factors for low bone density or fractures generally have moderate-to-high sensitivity and low specificity, many have not been validated, and none have been widely tested in a practice setting. Among different bone density tests measured at various sites, bone density measured at the femoral neck by dual-energy x-ray absorptiometry is the best predictor of hip fracture and is comparable to forearm measurements for predicting fractures at other sites. Women with low bone density have a 40% to 50% reduction in fracture risk when treated with raloxifene (vertebral fractures) or bisphosphonates (both vertebral and nonvertebral fractures). Trials of estrogen are inconclusive because of methodologic limitations.

Authors' recommendations: Although there is no direct evidence that screening prevents fractures, there is evidence that the prevalences of osteoporosis and fractures increase with age, that the short-term risk of fracture can be estimated by bone measurement tests and risk factor assessment, and that treatment may reduce fracture risk among women with low bone density.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/uspstf/uspsoste.htm

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)