Is osteoporosis screening in postmenopausal women effective?
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No single study evaluates the effectiveness of osteoporosis screening. However, screening women over the age of 65 years -- or those between 60-64 years with certain risk factors -- is recommended based on available evidence. First, osteoporosis is common, and its prevalence increases with age (strength of recommendation [SOR]: A - prospective cohort studies). Second, low bone mineral density predicts fracture risk (SOR: A - prospective cohort studies). Finally, the likelihood of osteoporotic fracture is reduced with therapy, such as alendronate 10 mg/day or risedronate 5 mg/day plus adequate daily calcium and vitamin D (SOR: A - meta-analysis of randomized clinical trials). Women under 60 years should not be screened (SOR: B--clinical decision rule). There is no evidence to guide decisions about screening interval or at what age to stop screening. The long-term risks of newer medications used for osteoporosis are unknown.
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