WHEN TO REPEAT OSTEOPOROSIS SCREENING
November 18, 2021 - Current guidelines recommend that all women 65 years of age or older be screened for osteoporosis with bone mineral density (BMD) testing. The guidelines do not, however, make recommendations on when to rescreen women. In practice, rescreening intervals are all over the place, with some patients never being rescreened and others receiving yearly BMD testing. The latter is particularly true if the practice owns a machine - mind you, nobody is accusing anybody of anything here. No randomized controlled trials have evaluated this issue, so guidance on rescreening is difficult to find.
The most informative paper published on this topic was a cohort study that looked at the risk of osteoporosis in postmenopausal women 65 years of age and older based on their initial T-scores. For women with a T-score less than -1.0, it took an average of 17 years for 10% to develop osteoporosis. For women with T-scores in the range of -1.01 to -1.49, the average was 17.3 years. For -1.50 to -1.99, the average was 4.7 years, and for -2.0 to -2.49, the average was 1.1 years. [SH review]
Using data from the study above and several other analyses, authors of a JAMA review article devised recommendations for appropriate rescreening intervals based on initial BMD results and estimated fracture risk. Recommendations from that article are available at this link - suggested rescreening intervals
Patients who have had BMD screening often want to know when they should repeat it. Given the dearth of good information on this topic, the suggestions in the review article are helpful and better than guessing.