Women Receive Bone Tests Too Often for Osteoporosis

NEW YORK - Bone loss and osteoporosis develop so slowly in most women whose bones test normal at age 65 that many can safely wait as long as 15 years before having a second bone density test, researchers report in a new study.


The study, published in today’s issue of The New England Journal of Medicine, is part of a broad rethinking of how to diagnose and treat the potentially debilitating bone disease that can lead to broken hips and collapsing spines.


A class of drugs, bisphosphonates, has been found to prevent fractures in people with osteoporosis. But medical experts no longer recommend the medicines to prevent osteoporosis itself. They no longer want women to take them indefinitely, and they no longer consider bone density measurements to be the single defining factor in deciding if a woman needs to be treated.




Now, with the new study, researchers are asking whether frequent bone density measurements even make sense for the majority of older women whose bone density is not close to a danger zone on an initial test.


Some doctors prescribe tests every two years because Medicare, the U.S. health plan for those 65 and older, reimburses for the exams on that schedule, Gourlay said. The research team tracked patients to gather available evidence to avoid health decisions made on “marketing, advocacy, and public beliefs that have encouraged overtesting and overtreatment,” the report said.


Just as a lack of information has caused some doctors to test too often, it has led others to ignore osteoporosis completely, Gourlay said. Patients don’t remind doctors about an initial osteoporosis screening, which is not as common as mammograms for breast cancer or tests for cholesterol, she said.


The study followed about 5,000 mostly white women over 15 years and regularly tested their bone mass starting at age 67. Gourlay said the group’s next goals include gathering data about osteoporosis treatment in men and in women younger than 65.