What is the Number of Older Canadians Needed to Screen by Measurement of Bone Density to Detect an Undiagnosed Case of Osteoporosis? A Population-Based Study From CaMos (original) (raw)

2006, Journal of Clinical Densitometry

Routine bone mineral densitometry (BMD) screening has been recommended for women aged 65 yr (Osteoporosis Canada [OC], International Society for Clinical Densitometry [ISCD], Canadian and United States Task Forces on Preventative Healthcare, and National Osteoporosis Foundation) and for men 65 yr (OC) or 70 yr (ISCD). We estimated the number of older Canadians needed to screen (NNS) by BMD to detect an undiagnosed case of osteoporosis, using prospective, multicenter, population-based data from the Canadian Multicentre Osteoporosis Study (CaMos). We included participants aged 65 yr with baseline dual-energy X-ray absorptiometry (DXA) BMDs at the femoral neck and lumbar spine (L1eL4). Osteoporosis was defined by a T-score 2.5 at either site. Patients were questioned about a prior diagnosis of osteoporosis. We studied 2699 women and 1032 men aged 65 yr. The percentage prevalence and 95% confidence intervals were determined. In individuals aged 65 yr, the prevalence of osteoporosis was 25.6% in women (95% confidence interval, 24.0%, 27.3%) and 8.9% in men (7.3%, 10.8%). In 652 men aged 70 yr, the prevalence of osteoporosis was 11.3% (9.1%, 14.0%). Of the participants with BMD-defined osteoporosis, 76.6% of woman aged 65 yr (73.2%, 79.6%; 516 of 674 women), 93.4% of men aged 65 yr (86.4%, 96.9%; 85 of 91), and 93.2% of men 70 yr (84.9%, 97.0%; 68 of 73) were not aware of it. Thus, the minimum NNS by BMD testing to detect one previously undiagnosed case of osteoporosis in Canada is: 6 women aged 65 yr, 13 men aged 65 yr, and 10 men aged 70 yr.