Osteoporosis Screening: What a New Report Tells Us
By Lisa Larkin, MD, FACP, NCMP, IF
Confused about when to get bone density testing? A new report released in July from the U.S. Preventative Services Task Force hopes to provide guidelines for women, but men should also take note.
Everyone begins to lose bone density as we age, especially past the age of 30. But reduced estrogen production in post-menopausal women (who are not on hormone replacement therapy) can slow the development of new bone tissue, putting older women at greater risk of osteoporosis and fractures. For men, bone loss is more gradual but tends to become medically significant after age 70.
Why is screening so important? Most people don’t realize they have porous or fragile bones until it’s too late – after they develop a fracture. Screening can determine those at risk, and treatments can be started to improve bone health before a fracture happens.
The bone density test is simple, painless, non-invasive and uses a low level of radiation (50 times lower than a mammogram.) Doctors use simple screening tools to determine who should have bone density testing, and while there are a few variations of the screening tool, they all consider the patient’s age and weight. (Some tools also factor in family history of fractures, smoking and alcohol consumptions and others.)
If osteoporosis is detected, there are treatments. Women are most often treated with bisphosphonates, prescription medications (such as Fosamax and Actonel) that decrease how quickly the body removes old bone, allowing time to for the body to grow new bone tissue. Other treatments include estrogen therapy or injectable medications.
The bottom line? Women over 65 should continue screenings. Women past menopause but under age 65 should talk with their doctor about other risk factors that might impact their individual risk and determine if testing is wise.
The U.S. Preventative Services Task Force admits there are fewer studies on men, so the guidelines are not as clear. But men, especially over 70, should talk with their provider about their risks and determine if and when testing makes sense for them.