Clinical Guidelines and Standards Guidelines by Issuing Body

Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement

US Preventive Services Task Force, Nicholson WK, Silverstein M, Wong JB, Chelmow D, Coker TR, Davis EM, Jaén CR, Krousel-Wood M, Lee S, Li L, Mangione CM, Ogedegbe G, Rao G, Ruiz JM, Stevermer J, Tsevat J, Underwood SM, Wiehe S

Published February 11, 2025 JAMA, 333(6), 498-508
DOI 10.1001/jama.2024.27154 PMID 39808425

RRM Academy Synopsis

USPSTF backs bone screening for women 65+ or at risk after menopause

In a 2025 statement, the US Preventive Services Task Force (USPSTF) recommends osteoporosis screening among women 65 years or older. It reports moderate certainty of moderate net benefit for these women and postmenopausal women under 65 at increased risk. The statement concerns adults without known osteoporosis or a past fragility fracture. Evidence on men is insufficient, the Task Force concludes.

Key Findings

  • Women 65 years or older receive a B recommendation for osteoporosis screening, with moderate certainty of a moderate net benefit.
  • Postmenopausal women younger than 65 years receive the same B recommendation when clinical risk assessment places them at increased fracture risk.
  • For men, the Task Force labels the evidence grade I, meaning it is insufficient to weigh benefits against harms.

Interpretation

The source is the published abstract of a Task Force recommendation statement. The statement rests on a systematic review of screening benefits and harms among adults aged 40 years or older who have neither a known osteoporosis diagnosis nor a past fragility fracture. The Task Force reports moderate certainty for the two groups of women it recommends screening, and the evidence for men leaves the balance of benefits and harms undetermined. This synopsis uses the abstract alone.

RRM Context

The statement links osteoporotic fractures to distress, lost independence and death. Restorative reproductive medicine treats the menstrual cycle as a vital sign. Healthy ovulation in the reproductive years is studied as one contributor to later bone health. Fracture prevention after menopause belongs to the same lifespan view.

Abstract

Importance

Osteoporotic fractures are associated with psychological distress, subsequent fractures, loss of independence, reduced ability to perform activities of daily living, and death.

Objective

The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the evidence on the benefits and harms of screening for osteoporosis to prevent fractures in adults 40 years or older with no known diagnosis of osteoporosis or history of fragility fracture.

Population

Adults 40 years or older without known osteoporosis or history of fragility fractures.

Evidence Assessment

The USPSTF concludes with moderate certainty that screening for osteoporosis to prevent osteoporotic fractures in women 65 years or older has moderate net benefit. The USPSTF concludes with moderate certainty that screening for osteoporosis to prevent osteoporotic fractures in postmenopausal women younger than 65 years at increased risk has moderate net benefit. The USPSTF concludes that the evidence is insufficient and the balance of benefits and harms for screening for osteoporosis to prevent osteoporotic fractures in men cannot be determined.

Recommendations

The USPSTF recommends screening for osteoporosis to prevent osteoporotic fractures in women 65 years or older. (B recommendation) The USPSTF recommends screening for osteoporosis to prevent osteoporotic fractures in postmenopausal women younger than 65 years who are at increased risk for an osteoporotic fracture as estimated by clinical risk assessment. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis to prevent osteoporotic fractures in men. (I statement).

Topics

By this author

Related research

Clinical Guidelines and Standards › Guidelines by Issuing Body › United States Professional Societies · Bone Health › Osteoporosis › Diagnosis and Treatment
Wanda K Nicholson, Michael Silverstein, John B Wong, David Chelmow, Tumaini Rucker Coker, Esa M Davis, Carlos Roberto Jaén, Marie Krousel-Wood, Sei Lee, Li Li, Carol M Mangione, Gbenga Ogedegbe, Goutham Rao, John M Ruiz, James Stevermer, Joel Tsevat, Sandra Millon Underwood, Sarah Wiehe
W Nicholson, Mike Silverstein, M Silverstein, Jack Wong, J Wong, Dave Chelmow, D Chelmow, T Coker, E Davis, C Jaén, M Krousel-Wood, S Lee, L Li, C Mangione, G Ogedegbe, G Rao, Jack Ruiz, J Ruiz, Jim Stevermer, Jimmy Stevermer, J Stevermer, J Tsevat, S Underwood, S Wiehe
PMID 39808425 39808425 DOI 10.1001/jama.2024.27154 10.1001/jama.2024.27154 Preventive Services Task Force et al. 2025, Preventive Services Task Force 2025