Souliotis Kyriakos, Golna Christina, Golnas Pavlos, Markakis Ioannis-Anestis & Makras Polyzois

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.

Aging Clinical and Experimental Research, 34, 2473-2481, 2022 DOI: