To screen or not to screen for osteoporosis amongst post-menopausal women with one prior osteoporotic fracture in Greece

Aging Clin Exp Res. 2022 Oct;34(10):2473-2481. doi: 10.1007/s40520-022-02183-z. Epub 2022 Jul 11.

Abstract

Background: Screening and linkage to care (SLTC) for osteoporosis is suboptimal in several settings. In Greece, it is estimated that only up to 8.6% of postmenopausal women are SLTC for osteoporosis, despite having suffered a previous fracture.

Aims: This study aims to estimate the impact of comprehensive screening on future fracture burden amongst post-menopausal women aged 50-74, with one prior osteoporotic fracture, in Greece.

Methods: We developed a cohort stochastic model, based on published epidemiological and clinical data, to assess impact of screening on future fracture burden in two scenarios: a current, assuming an 8.6% background SLTC, and a completely hypothetical, assuming 100% SLTC.

Results: Amongst a cohort of 50,000 post-menopausal women aged 50-74, with one prior osteoporotic fracture, applying the hypothetical versus the current scenario would result in a reduction in deaths (-0.6%) and fractures (-4.3%) over 10 years. The hypothetical scenario leads to greater reductions in costs associated with vertebral (-8.1%) and hip (-5.5%) fractures, followed by other non-vertebral (-3.0%) and forearm (-2.5%) fractures. In the hypothetical scenario, treatment initiations and total screenings increased almost tenfold versus the current scenario, at an estimated direct incremental cost of 27.83€ per woman per year in the cohort.

Discussion: Our study adds to the existing evidence on the impact of screening to prevent fractures amongst post-menopausal women. Despite being based on a stochastic model, our study confirms findings most recently published in the literature.

Conclusions: Our study models the positive public health impact of increasing SLTC levels amongst post-menopausal women with a prior osteoporotic fracture.

Keywords: Cost of care; Modelling; Osteoporosis burden; Osteoporotic fractures; Postmenopausal; Screening.

MeSH terms

  • Female
  • Greece / epidemiology
  • Humans
  • Osteoporosis* / complications
  • Osteoporosis* / diagnosis
  • Osteoporosis* / epidemiology
  • Osteoporosis, Postmenopausal* / complications
  • Osteoporosis, Postmenopausal* / diagnosis
  • Osteoporosis, Postmenopausal* / epidemiology
  • Osteoporotic Fractures* / diagnosis
  • Osteoporotic Fractures* / epidemiology
  • Postmenopause

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