Osteoporosis Screening in Postmenopausal Women 50-64 Years-Old: Comparison of U.S. Preventive Services Task Force Strategy and Two Traditional Strategies in the Women's Health Initiative.

Publication Type:

Journal Article


Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research (2014)


2014, February 2014, Public Health Sciences Division


The U.S. Preventive Services Task Force (USPSTF) recommends osteoporosis screening for women younger than 65 years whose 10-year predicted risk of major osteoporotic fracture is ≥ 9.3%. For identifying screening candidates among women aged 50-64 years, it is uncertain how the USPSTF strategy compares with the Osteoporosis Self-Assessment Tool (OST) and the Simple Calculated Osteoporosis Risk Estimate (SCORE). We examined data (1994-2012) from 5165 Women's Health Initiative participants aged 50-64. For the USPSTF (FRAX major fracture risk ≥ 9.3% calculated without BMD), OST (score <2), and SCORE (score >7) strategies, we assessed sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) to discriminate between those with and without femoral neck (FN) T-score ≤ -2.5. Sensitivity, specificity, and AUC for identifying FN T-score ≤ -2.5 were 34.1%, 85.8%, and 0.60 for USPSTF (FRAX), 74.0%, 70.8%, and 0.72 for SCORE, and 79.8%, 66.3%, and 0.73 for OST. The USPSTF strategy identified about 1/3(rd) of women aged 50-64 with FN T-scores ≤ -2.5. Among women aged 50-64 years, the USPSTF strategy was modestly better than chance alone and inferior to conventional SCORE and OST strategies in discriminating between women with and without FN T-score ≤ -2.5. © 2014 American Society for Bone and Mineral Research.