10-year osteoporosis screening sufficient for older women with normal BMD
MedWire News: Postmenopausal women with normal bone mineral density (BMD) may not need further osteoporosis screening for at least 10 years, according to study results presented at The American Society for Bone and Mineral Research Annual Meeting in Toronto, Canada, this week.
This is in contrast to the US Preventive Services Task Force suggestion that osteoporosis screening every 2 years is appropriate for women aged 65 years and older, said Margaret Gourlay from the University of North Carolina in Chapel Hill, USA.
"If a woman's bone density at age 67 is very good, then she doesn't need to be re-screened in 2 years or 3 years, because we're not likely to see much change," Gourlay said.
"Our study found it would take about 16 years for 10% of women in the highest bone density ranges to develop osteoporosis," she added.
Gourlay and team prospectively followed 5035 women aged 67 years and older for 15 years as part of the Study of Osteoporotic Fractures. During this period participants had their BMD measured by dual energy X-ray absorptiometry (DXA) up to five times.
The women were grouped according to their BMD at baseline into those with a high risk for osteoporosis (T-score from -2.49 to -2.00), those with a medium risk (T-score from -1.99 to -1.50), those with a low risk (T-score of -1.49 to -1.01), and those with normal BMD (T-score of -1.00 or higher).
The researchers estimated how long it would take for 10% of the women in each T-score group to transition to osteoporosis. For the high-risk group, the estimated time was 1.26 years, in contrast to 5.06 years for the moderate-risk group, and 16.10 years for the low-risk and normal BMD groups.
"These results suggest that baseline BMD is the most important determinant of a screening interval, and that an interval of 1 year should be considered for older postmenopausal women with a T-score at or below -2.0," Gourlay remarked.
She added that an interval of up to 5 years may be reasonable for osteopenia with a T-score above -2.0, whereas repeat DXA before 10 years is unlikely to be informative among women with normal BMD.
However, "doctors may adjust these time intervals for a number of reasons, but our results offer an evidence-based starting point for this clinical decision," she said.
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By Laura Dean