What is the Number of Older Canadians Needed to Screen by Measurement of Bone Density to Detect an Undiagnosed Case of Osteoporosis? A Population-Based Study From CaMos

Sawka, Anna M.; Papaioannou, Alexandra; Josse, Robert G.; Murray, Timothy M.; Ioannidis, George; Hanley, David A.; Prior, Jerilynn C.; Thabane, Lehana; Papadimitropoulos, E.A.; Gafni, Amiram; Pickard, Laura; Anastassiades, Tassos; Kirkland, Susan; Adachi, Jonathan D.; the CaMos Research Group,

doi:10.1016/j.jocd.2006.07.004

« Previous Next »Journal of Clinical Densitometry
Volume 9, Issue 4 , Pages 413-418, October 2006

What is the Number of Older Canadians Needed to Screen by Measurement of Bone Density to Detect an Undiagnosed Case of Osteoporosis? A Population-Based Study From CaMos

Anna M. Sawka
- Department of Medicine, Division of Endocrinology, University of Toronto, Toronto, Ontario
- Department of Medicine, Division of Endocrinology, University Health Network, Toronto, Ontario
- Address correspondence to: Anna M. Sawka, Toronto General Hospital, 200 Elizabeth Street, Eaton North 12-212, Toronto, Ontario M5G 2C4, Canada.
Alexandra Papaioannou
- Department of Medicine, McMaster University, Hamilton, Ontario
- Department of Medicine, Hamilton Health Sciences, Hamilton, Ontario
Robert G. Josse
- Department of Medicine, Division of Endocrinology, University of Toronto, Toronto, Ontario
- Division of Endocrinology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario
Timothy M. Murray
- Department of Medicine, Division of Endocrinology, University of Toronto, Toronto, Ontario
- Division of Endocrinology, Department of Medicine, St. Michael's Hospital, Toronto, Ontario
George Ioannidis
- Department of Medicine, Division of Rheumatology, St. Joseph's Healthcare, Hamilton, Ontario
David A. Hanley
- Department of Medicine, Division of Endocrinology, University of Calgary, Calgary, Alberta
Jerilynn C. Prior
- Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, British Columbia
Lehana Thabane
- Department of Health Research Methodology, McMaster University, Hamilton, Ontario
- Centre for Evaluation of Medicines, Hamilton, Ontario
E.A. Papadimitropoulos
- University of Toronto Faculty of Pharmacy and Eli Lilly Canada, Toronto, Ontario
Amiram Gafni
- Department of Health Research Methodology, McMaster University, Hamilton, Ontario
- Centre for Health Economics and Policy Analysis, Hamilton, Ontario
Laura Pickard
- Department of Medicine, Division of Rheumatology, St. Joseph's Healthcare, Hamilton, Ontario
Tassos Anastassiades
- Department of Medicine, Division of Rheumatology, Queens University, Kingston, Ontario
Susan Kirkland
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia
Jonathan D. Adachi
- Department of Medicine, McMaster University, Hamilton, Ontario
- Department of Medicine, Division of Rheumatology, St. Joseph's Healthcare, Hamilton, Ontario
the CaMos Research Group
- Canadian Multicentre Osteoporosis Study Research Group, Canada

Received 26 April 2006; received in revised form 17 July 2006; accepted 19 July 2006. published online 31 August 2006.

Abstract

Routine bone mineral densitometry (BMD) screening has been recommended for women aged ≥65 yr (Osteoporosis Canada [OC], International Society for Clinical Densitometry [ISCD], Canadian and United States Task Forces on Preventative Healthcare, and National Osteoporosis Foundation) and for men ≥65 yr (OC) or ≥70 yr (ISCD). We estimated the number of older Canadians needed to screen (NNS) by BMD to detect an undiagnosed case of osteoporosis, using prospective, multicenter, population-based data from the Canadian Multicentre Osteoporosis Study (CaMos). We included participants aged ≥65 yr with baseline dual-energy X-ray absorptiometry (DXA) BMDs at the femoral neck and lumbar spine (L1–L4). Osteoporosis was defined by a T-score ≤2.5 at either site. Patients were questioned about a prior diagnosis of osteoporosis. We studied 2699 women and 1032 men aged ≥65 yr. The percentage prevalence and 95% confidence intervals were determined. In individuals aged ≥65 yr, the prevalence of osteoporosis was 25.6% in women (95% confidence interval, 24.0%, 27.3%) and 8.9% in men (7.3%, 10.8%). In 652 men aged ≥70 yr, the prevalence of osteoporosis was 11.3% (9.1%, 14.0%). Of the participants with BMD-defined osteoporosis, 76.6% of woman aged ≥65 yr (73.2%, 79.6%; 516 of 674 women), 93.4% of men aged ≥65 yr (86.4%, 96.9%; 85 of 91), and 93.2% of men ≥70 yr (84.9%, 97.0%; 68 of 73) were not aware of it. Thus, the minimum NNS by BMD testing to detect one previously undiagnosed case of osteoporosis in Canada is: 6 women aged ≥65 yr, 13 men aged ≥65 yr, and 10 men aged ≥70 yr.