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USPSTF floats new osteoporosis screening guidelines

by Brendon Nafziger, DOTmed News Associate Editor | July 06, 2010
The USPSTF updates
its osteoporosis screening
guidelines.
The United States Preventive Services Task Force has floated a series of guidelines that could lower the age of screening for women at high-risk of osteoporosis, but without making recommendations for men or how frequently screenings should happen.

The proposed guidelines would call for screening of women under age 65 if they present the same 10-year risk for fracture as a woman over 65, but remains agnostic on screening intervals and what works for men, the USPSTF announced Monday evening.

Perhaps more significant than any change, the proposed recommendations will be up for public comment for around 60 days, giving doctors, patients and others a chance to argue over the guidelines before the widely influential agency makes them final.

This is only the second time the agency has put up guidelines for public comment. The first, in October, was when the group pilot-tested public review of proposed recommendations on screening for children with visual impairment. But that was done quietly to see how the process would turn out, the agency said.

"We want to open the doors," Dr. Bruce N. Calonge, chair of the USPSTF and an epidemiologist with the Colorado Department of Public Health, told DOTMed News by phone Monday. "While we do believe that ultimately the review of the evidence needs to occur free from politics, advocacy and special interest, it doesn't mean we need to do it outside the public eye."

Although the agency has intended to "open up" the recommendation-making process since 2008, by bringing the guidelines before the public before finalizing them, the agency also hopes to avoid the backlash it got for its controversial breast screening recommendations in November.

Although the USPSTF doesn't directly dictate health care policy, its recommendations are thought to carry great weight, as they're often followed by Medicare and, in turn, by many private health insurance companies.

LOWERING AGE OF SCREENING

The new recommendations, if accepted, would overturn the USPSTF's earlier guidelines for osteoporosis screening in 2002, that suggested postmenopausal women over 65 and high-risk women between 60 and 64 receive screenings, but gave no advice for women under 60.

"While we were moderately certain that fracture risk was low under age 60, research in actual fracture risk has expanded since that time, and there's evidence that you can have a risk that is the same as or exceeds the fracture risk of a 65-year-old woman if you have enough risk factors," Calonge said.