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SCREENING

OsteoporosisWomen 65+ and Younger Women at Increased Risk

GRADE

Recommended

SPECIFIC RECOMMENDATIONS

The USPSTF recommends screening for osteoporosis in women aged 65 years or older and in younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors.

FREQUENCY OF SERVICE

The potential value of rescreening women whose initial screening test did not detect osteoporosis is to improve fracture risk prediction. A lack of evidence exists about optimal intervals for repeated screening and whether repeated screening is necessary in a woman with normal BMD. Because of limitations in the precision of testing, a minimum of 2 years may be needed to reliably measure a change in BMD; however, longer intervals may be necessary to improve fracture risk prediction.

RISK FACTOR INFORMATION

Based on the U.S. FRAX tool, a 65-year-old white woman with no other risk factors has a 9.3% 10-year risk for any osteoporotic fracture. White women between the ages of 50 and 64 years with equivalent or greater 10-year fracture risks based on specific risk factors include but are not limited to the following persons:

  1. a 50-year-old current smoker with a BMI less than 21 kg/m daily alcohol use, and parental fracture history
  2. a 55-year-old woman with a parental fracture history
  3. a 60-year-old woman with a BMI less than 21 kg/m daily alcohol use
  4. a 60-year-old current smoker with daily alcohol use. The FRAX tool also predicts 10-year fracture risks for black, Asian, and Hispanic women in the United States. In general, estimated fracture risks in nonwhite women are lower than those for white women of the same age.