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ACP Issues Guideline for Screening for Osteoporosis in Men

Osteoporosis is not just a women’s health issue; rates among men are expected to increase 50 percent over the next 15 years

PHILADELPHIA, May 6, 2008 – The American College of Physicians (ACP) today released a new clinical practice guideline on screening for osteoporosis in men. Studies show that osteoporotic fractures result in substantial disease, death, and health costs in men.

“Older men, especially those over the age of 65, need to be assessed regularly for risk factors for osteoporosis,” says Amir Qaseem, MD, PhD, MHA, senior medical associate in ACP’s Clinical Programs and Quality of Care Department. “Osteoporosis is not just a women's disease. It is significantly underdiagnosed and undertreated in men. Not enough older men are being screened.”

Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased risk of fractures of the hip, spine, and wrist.

The guideline calls for physicians to periodically assess the risk factors for osteoporosis in older men. Clinicians should obtain a DXA (dual-energy x-ray absorptiometry) scan for men who are at increased risk for osteoporosis and are candidates for drug therapy. ACP also recommends further research to evaluate osteoporosis screening tests in men.

Risk factors for osteoporosis in men are older age, low body weight, weight loss, physical inactivity, previous fractures not caused by substantial trauma, ongoing use of certain drugs (such as corticosteroids like prednisone or drugs that are sometimes used to treat prostate cancer), and low-calcium diets.

The prevalence of osteoporosis is estimated to be 7 percent in white men, 5 percent in African American men, and 3 percent in Hispanic American men. However, with the aging population, the rates of osteoporosis in men are expected to increase nearly 50 percent in the next 15 years, and hip fracture rates are projected to double by 2040.

The guideline, published in the May 6, 2008, issue of Annals of Internal Medicine, is based on a systematic evidence review of previously published studies.

Annals of Internal Medicine is one of the most widely cited peer-reviewed medical journals in the world. The journal has been published for 81 years and accepts only 7 percent of the original research studies submitted for publication. Annals of Internal Medicine is published by the American College of Physicians, the largest medical specialty organization and the second-largest physician group in the United States.

ACP members include 125,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults.

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