Effectiveness of Early Detection and Intervention

Treating osteoporosis with bisphosphonates reduces the risk of fracture (Nelson and Helfand, 2002). Estrogen, calcitonin, and selective estrogen receptor modulators have also been used to increase bone density and reduce fractures. The benefits of these treatments are greater for women at high risk for fracture than women at lower risk. Benefits of screening increase substantially with older age, particularly for women older than 65 and for women with important risk factors. In women age 60 to 64 who have risk factors, the benefits of screening are comparable to those of women age 65 to 69.

Several potential harms are associated with screening and treatment. An unwarranted diagnosis of osteoporosis may provoke anxiety. Potential harms may also arise from misinterpretation of BMD tests. Patients may have side effects from the medication; bisphosphonates often cause gastrointestinal side effects. The cost and inconvenience of undergoing multiple confirmatory tests must be considered.

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