Professional Development

Osteoporosis screening guidelines for men issued

Last Updated: 2008-05-05 17:14:21 -0400 (Reuters Health)

NEW YORK (Reuters Health) - A clinical practice guideline issued today by the American College of Physicians recommends that physicians periodically assess older men for risk factors for osteoporosis.

Men who are at increased risk for osteoporosis and are candidates for drug therapy should undergo a dual-energy X-ray absorptiometry (DXA) scan, the guideline states. It also calls for further research to evaluate osteoporosis screening tests in men and that, presently, non-DXA tests are either "too insensitive or have insufficient data to reach conclusions."

The guidelines, published in the May 6th issue of the Annals of Internal Medicine, are based on a systematic evidence review of previously published studies.

According to the ACP, research has shown that osteoporotic fractures result in substantial disease, death, and health costs in men. The 1-year mortality rate in men after hip fracture is twice that in women.

"Older men, especially those over the age of 65, need to be assessed regularly for risk factors for osteoporosis," said Dr. Amir Qaseem, senior medical associate in ACP's Clinical Programs and Quality of Care Department. "Osteoporosis is not just a women's disease. It is significantly underdiagnosed and undertreated in men (and) not enough older men are being screened."

Risk factors for osteoporosis in men include older age, low body weight, weight loss, physical inactivity, previous osteoporotic fracture, prolonged corticosteroid use and androgen deprivation therapy.

With the aging of the U.S. population, rates of osteoporosis in men are expected to increase nearly 50% in the next 15 years, and hip fracture rates are projected to double by 2040, the ACP notes.

Ann Intern Med 2008;146:680-701.

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