Screening for Osteoporosis: A Draft Recommendation Statement from the Japan Preventive Services Task Force
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
The US Preventive Services Task Force (USPSTF) recommends screening for osteoporosis to prevent osteoporotic fractures in women 65 years or older and postmenopausal women younger than 65 years at increased risk. However, whether osteoporosis screening has net benefit among the Japanese population, which has one of the most aging populations in the world, remains unclear.The Japan Preventive Services Task Force (JPPSTF) reviewed the USPSTF draft recommendation published in 2024, commissioned an independent literature review to account for Japan's specific context, and developed its own version of the recommendation adapted to the context of Japanese population.This recommendation targets Japanese adults aged 40 years and older without a history of osteoporosis or fragility fractures.Osteoporosis screening consists of two steps. Primary screening: Initial assessment using at least one of the following methods: peripheral DXA, QUS, or clinical risk assessment tools such as FRAX. Secondary screening: Comprehensive assessment including central DXA- based bone mineral density measurement.The JPPSTF concludes with moderate certainty that osteoporosis screening in postmenopausal women provides a moderate net benefit in Japan. In contrast, the evidence is insufficient to determine the balance of benefits and harms of osteoporosis screening inpremenopausal women and men in Japan.The JPPSTF recommends osteoporosis screening for postmenopausal women in Japan (Grade B).Women aged 65 and older: May begin screening directly with secondary screening. Postmenopausal women under age 65: First undergo primary screening using at least one of the following methods: peripheral DXA, QUS, or clinical risk assessment tools such as FRAX. If the YAM (young adult mean) score is below 80% (or equivalent), or if clinical risk is considered high, proceed to secondary screening including central DXA.For premenopausal women and men, the JPPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms in Japan (I statement).