Many Young, Post-Menopausal Women are Excluded from Osteoporosis Screenings
Osteoporosis screenings can reduce women's risk of bone fractures. In a new study, researchers examined the United States Preventive Services Task Force's (USPSTF) screening guidelines for young, post-menopausal women and discovered that the guidelines were not very effective, causing women to miss out on screenings.
"If we want to prevent fractures, we need tools that help us accurately predict who will suffer these osteoporotic injuries so that we can target these at-risk people for preventive measures," Dr. Carolyn Crandall, professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, and the study's primary investigator, said. "Our results suggest that our current guidelines for screening in younger post-menopausal women do not accurately identify who will suffer a fracture."
The USPSTF currently recommends all women at and over the age of 65 to get their bone mineral density levels checked. For young, post-menopausal women between 50 and 64, the guidelines only recommend those who have a 10-year risk of a hip, vertebral, humerus or wrist fracture of 9.3 percent or greater to get screened. Risk was assessed using the Fracture Risk Assessment Tool.
In order to study the effectiveness of using the assessment tool, the researchers analyzed data on 62, 492 postmenopausal women aged 50 to 64 taken from the Women's Health Initiative. 85 percent of them were white, nine percent black, and four percent Hispanic.
The team found that the USPSTF screening method successfully predicted only 25.8 percent of the women at risk of suffering from a bone fracture in 10 years. The team also examined the effectiveness of two other screening tools, which were the Osteoporosis Self Assessment Tool (OST) and the Simple Calculated Osteoporosis Risk Estimation Tool (SCORE). These options were not any more effective in predicting at-risk women that should be screened. The OSA accurately predicted risk for 39.8 percent of the women and the SCORE captured the risk for 38.6 percent.
"Neither the USPSTF nor the other two screening strategies performed better than chance alone in discriminating women who did and did not have subsequent fractures," the researchers concluded according to the press release. "These findings highlight the pressing need for further prospective evaluation of alternative strategies with the goal of better targeting resources to at-risk young postmenopausal women. Our findings do not support use of the USPSTF strategy or the other tools we tested to identify younger postmenopausal women who are at higher risk of fracture."
The study was published in The Journal of Clinical Endocrinology & Metabolism.