Christopher Nordin, MD
Potential Conflicts of Interest: None disclosed.
Nordin C. Screening for Osteoporosis: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2011;155:276. doi: 10.7326/0003-4819-155-4-201108160-00021
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Published: Ann Intern Med. 2011;155(4):276.
TO THE EDITOR:
The USPSTF (1) recommends that screening for osteoporosis be done 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 with no additional risk factors. This is a very disappointing outcome because it fails to distinguish between prevention of osteoporosis and prevention of fractures in women who already have osteoporosis.
Osteoporosis is a major risk factor for fracture, similar to hypertension as a risk factor for stroke and blood cholesterol for coronary heart disease (2). Prevention of strokes by measuring blood pressure at midlife and treating it, if necessary, is routine medical practice, as is measurement of blood lipids at midlife and treatment of hyperlipidemia to prevent heart attacks. No competent physician would delay measurement of blood pressure or cholesterol to age 65 years, by which time vascular damage may be well advanced, but the USPSTF seriously recommends that we should wait until women have lost about 25% of their bone mass before measuring their BMD.
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