Excessive osteoporosis screening in women under 65 years: a cross-sectional study

https://doi.org/10.18294/sc.2016.841

Published 4 October 2016 Open Access


Médica de familia. Médica asociada. Docente, Departamento de Medicina, Instituto Universitario del Hospital Italiano de Buenos Aires, Argentina. image/svg+xml , Médico de familia. Investigador Formado. Médico de Planta, Servicio de Medicina Familiar y Comunitaria, Hospital Italiano de Buenos Aires. Docente, Departamento de Salud Pública, Instituto Universitario del Hospital Italiano de Buenos Aires. Argentina. image/svg+xml , Médica de familia. Jefa, Servicio de Medicina Familiar y Comunitaria, Hospital Italiano de Buenos Aires. Directora, Departamento de Investigación, Instituto Universitario del Hospital Italiano de Buenos Aires, Argentina. image/svg+xml



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Keywords:

Osteoporosis, Mass Screening, Health Services Misuse, Argentina

Abstract


Overuse of osteoporosis screening in women at low risk of fracture may lead to overdiagnosis, inappropriate treatment and medicalization. The objective of this work was to estimate the proportion of women aged 45 to 64 enrolled in a private health insurance plan in Buenos Aires undergoing hip dual-energy x-ray absorptiometry (DXA) in 2011 without meeting osteoporosis screening criteria. In this cross-sectional study, 4310 women of this age range that had undergone a hip DXA were identified. A randomly selected sub-group of 401 women was then assessed for the presence of risk factors for osteoporosis and complete data were retrieved for 178 women. Appropriate screening was defined by two criteria: 1) having a 10-year fracture risk higher than that of a 65-year old woman (estimated using the FRAX® tool); 2) having at least one risk factor for fracture. It was found that 86.5% of the women who underwent hip DXA did not exceed the minimum 10-year fracture risk threshold required for screening; 5.8% of them had osteoporosis and 61.0% osteopenia. According to the second criterion, 49.4% had no risk factors, 3.4% of these women had osteoporosis and 62.5% osteopenia. The results show that at least half the women screened did not meet osteoporosis screening criteria.

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