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The criteria required for an effective screening strategy for osteoporosis are largely met in Caucasian women. The disease is common and readily diagnosed by the measurement of bone mineral with single- or dual-energy absorptiometry. Such measurements have high specificity but lower sensitivity, so that the value of the technique is greater for those identified as being at higher risk. Against this background there is little evidence that osteoporosis can usefully be tackled by a public health policy to influence risk factors such as smoking, exercise and nutrition. This suggests that it is appropriate to consider targetting of treatment with agents affecting bone metabolism to susceptible individuals. Since the main benefits of the use of hormone replacement therapy (HRT) are probably on cardiovascular morbidity, the major role for selective screening is to direct non-HRT interventions. An appropriate time to consider screening and intervention is at the menopause, but screening at later ages is also worthy of consideration. Since the cost of screening is low and that of bone-active drugs is high, the selective use of screening techniques will improve the cost-benefit ratio of intervention.

Original publication

DOI

10.1007/bf01622200

Type

Journal article

Journal

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA

Publication Date

11/1994

Volume

4

Pages

368 - 381

Addresses

WHO Collaborating Centre for Metabolic Bone Disease, University of Sheffield Medical School, UK.

Keywords

Humans, Osteoporosis, Postmenopausal, Spinal Fractures, Hip Fractures, Colles' Fracture, Estrogen Replacement Therapy, Risk Factors, Bone Density, Adult, Aged, Aged, 80 and over, Middle Aged, World Health Organization, Female