USPSTF Issues Draft Recommendations for Osteoporosis Screening

The United States Preventive Services Task Force (USPSTF) has issued an updated draft recommendation statement on osteoporosis screening to prevent fractures.

The Task Force’s recommendations, which are an update to the previous 2011 guidelines, are based on review of the quality of evidence available to advise health care providers when screening of osteoporosis is appropriate. According to the USPSTF assessment, the Task Force concluded:

• With moderate certainty that the net benefit of screening for osteoporosis in women aged 65 years and older is at least moderate (B recommendation).
• With moderate certainty that the net benefit of screening of osteoporosis in postmenopausal women younger than 65 years of age who are at increased risk of osteoporosis is at least moderate (B recommendation).
• Current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis in men (Insufficent statement).

The USPSTF guidelines point to convincing evidence that bone measurement tests are accurate for predicting osteoporotic fractures in women and men, and adequate evidence that clinical risk assessment tools are moderately accurate in identifying risk of osteoporosis and related fractures.

Health care providers should consider risk factors when deciding whether to screen women under the age of 65. These risk factors include parental history of hip fracture, smoking, excess alcohol consumption, low body weight, and menopausal status.

For women who are at an increased risk, the Fracture Risk Assessment Tool (FRAX) is commonly used to assess the 10-year risk for fracture. The Task Force determined that it is reasonable to test postmenopausal women younger than 65 years of age who have a FRAX risk of major osteoporotic fracture greater than 8.4%, which is the newly updated cutoff compared to 9.3% recommended in the 2011 guidelines.

The draft recommendation is open for public comment until December 4, 2017.

Reference

Draft Recommendation Statement. Osteoporosis to Prevent Fractures: Screening. USPSTF’s website. 2017. https://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement/osteoporosis-screening1. Accessed November 7, 2017.