WHAT’S NEW: Many DEXA scans can be eliminated
Rescreening all postmenopausal women every 2 years is unlikely to reduce osteoporotic fractures. This cohort study provides evidence that rescreening can often be delayed for many years, depending on the patient’s baseline risk. Changing practice based on these findings can reduce resource utilization without adversely affecting women’s health
CAVEATS: Questions about applicability may remain
This analysis was limited to women ≥67 years, so different results might be obtained from analyses that included younger postmenopausal women. In addition, 99% of the participants were white. Because the prevalence of osteoporosis of the hip among white women is equal to or slightly higher than it is among nonwhite women, it is likely that the suggested intervals are reasonable estimates for women of all races
In women >80 years, the interval between baseline testing and the development of osteoporosis was shorter than that of their younger counterparts. Thus, it might be reasonable to reduce rescreening intervals by a third for women in their 80s
CHALLENGES TO IMPLEMENTATION: Education needed for patients and docs
This study is the best so far to address the frequency of rescreening. In order to implement it, patients as well as clinicians will need to be educated. Effective long-term (>10 y) reminder systems would improve implementation
The recommendations of professional associations may also be a factor. The National Osteoporosis Foundation recommends assessing BMD every 2 years, but notes that more frequent testing may sometimes be warranted.7 The American College of Preventive Medicine recommends that screening for osteoporosis not occur more often than every 2 years.8
Acknowledgement
The PURLs Surveillance System is supported in part by Grant Number UL1RR024999 from the National Center for Research Resources, a Clinical Translational Science Award to the University of Chicago. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of health.
