Prevalence of risk factors for fractures and use of DXA scanning in Danish women. A regional population-based study
- 167 Downloads
To determine the relationship between risk factors and use of DXA scans. Our study showed a relatively high use of DXA in low-risk women and the relatively low coverage in women with multiple risk factors. Moreover, distance to DXA clinics, age, and socio-economic factors are associated with the use of DXA.
To determine the relationship between risk factors for fracture and use of DXA scans in Danish women in relation to distance to DXA clinics and socio-economic factors.
From the Danish National Civil Register we randomly selected 5,000 women aged 40–90 years living in the region of Southern Denmark to receive a mailed questionnaire concerning risk factors for fractures.
The respondents rate was 84% and 77% of the invited population were available for analysis. A total of 10.3% of the women without risk factors and only 36% of the women with three or more risk factors had a history of DXA. The likelihood of a history of DXA was higher with increasing FRAX(™) 10-year risk; i.e., 8.7% and 30.2% in patients with a 10-year fracture risk of 0–14.9% and 25–100%, respectively. In women with less than 10 km to nearest DXA facility, 20.2% had a history of DXA, while 11.5% of those with more than 40 km to the nearest scanner had a history of DXA. Logistic regression analysis showed that distance, fracture risk, oral glucocorticoids, low-energy fracture, conditions associated with secondary osteoporosis, low BMI, history of falls, age 65–79 years, spouse status, and income were significantly associated with having a history of DXA.
Our study showed a relatively high use of DXA in low-risk women and the relatively low coverage in women with multiple risk factors. Moreover, distance to DXA clinics, age, and a number of socio-economic factors are associated with the use of DXA.
KeywordsCase-finding strategy DXA scan Epidemiology Risk factors Women
- 1.World Health Organisation (2007) Assessment of osteoporosis at primary health care level. World Health Organisation Scientific Group Technical Report 2007Google Scholar
- 5.U.S.Preventive Services Task Force (2009) The guide to clinical preventive services, 2009, Recommendations of the U.S. Preventive Services Task ForceGoogle Scholar
- 6.National Osteoporosis Foundation (2008) Clinician´s guide to prevention and treatment of osteoporosisGoogle Scholar
- 7.(2005) Sosial- og helsedirektoratet. Faglige retningslinjer for forebygging og behandling av osteoporose og osteoporotiske bruddGoogle Scholar
- 9.Kanis JA, Oden A, Johnell O, Johansson H, De Laet C, Brown J, Burckhardt P, Cooper C, Christiansen C, Cummings S, Eisman JA, Fujiwara S, Gluer C, Goltzman D, Hans D, Krieg MA, La CA, McCloskey E, Mellstrom D, Melton LJ III, Pols H, Reeve J, Sanders K, Schott AM, Silman A, Torgerson D, van ST, Watts NB, Yoshimura N (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–1046PubMedCrossRefGoogle Scholar
- 12.Rubin KH, Abrahamsen B, Hermann AP, Bech M, Gram J, Brixen K (2010) Fracture risk as assessed by the Fracture Risk Assessment Tool (FRAX®) in a random sample of women living in Denmark compared with fracture risk derived from population fracture rates and mortality rates. (In press)Google Scholar
- 14.Hyldstrup L, Brixen K, Eriksen EF, Gram J, Langdahl B, Schwartz P, Sørensen HA (2000) Osteoporose. Klaringsrapport fra Dansk Knoglemedicinsk SelskabGoogle Scholar
- 15.(2002) Dansk selskab for almen medicin. Osteoporose i almen praksis med fokus på forebyggelse af frakturer hos ældreGoogle Scholar
- 16.(2009) Dansk Knoglemedicinsk Selskab. Vejledning til udredning og behandling of OsteoporoseGoogle Scholar
- 19.Nationel Board of Health (2009) http://www.sst.dk/Indberetning%20og%20statistik/Sundhedsdata/Download_sundhedsstatistik/Behandling_ved_sygehuse/DSN.aspx
- 20.langtved data a s; www.langtved.dk. 2009
- 21.FRAX (2009); Fractures risk assessment tool; http://www.shef.ac.uk/FRAX/tool.jsp?locationValue=5
- 25.Ministry of social development, 2009 the social report. www.socialreport.msd.govt.nz/health/cigarette-smoking.html 2010
- 30.Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382PubMedCrossRefGoogle Scholar
- 32.de LC, Kanis JA, Oden A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV, Mellstrom D, Melton LJ III, Meunier PJ, Pols HA, Reeve J, Silman A, Tenenhouse A (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338CrossRefGoogle Scholar
- 33.Curtis JR, Laster A, Becker DJ, Carbone L, Gary LC, Kilgore ML, Matthews RS, Morrisey MA, Saag KG, Tanner SB, Delzell E (2009) The geographic availability and associated utilization of dual-energy X-ray absorptiometry (DXA) testing among older persons in the United States. Osteoporos Int 20:1553–1561PubMedCrossRefGoogle Scholar
- 34.Bilde L, Rasmussen SR (2006) Europæiske erfaringer med systematisk mammografiscreeningGoogle Scholar