An evaluation of bone density screening in premenopausal women

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Fractures due to osteoporosis are a major public health problem. Bone density is one of the major predictors of these osteoporotic fractures and is the result of the amount of bone gained in early life (i.e peak bone mass) and subsequent bone loss. Cigarette smoking, physical inactivity and inadequate calcium intake are widely regarded as risk factors for osteoporosis (as well as for other common diseases). Despite this information being widely available and actively promoted, the prevalence of these risk factors in the population remains unacceptably high suggesting that education alone at the public health level is not sufficient to modify these behaviours. In women (mean age 33) taking part in a study of the determinants of bone mass in children, we recently reported substantial change in these behaviours at 12 months follow-up when women received an information leaflet and individualised bone density information. These women were highly selected and it is unclear if this response is representative of all women. The aims of this study are, therefore, to test hypotheses in a random electoral roll sample of 400 women aged 25-44 from metropolitan Hobart relating to the effect of different types of educational programs and low initial bone mass on both lifestyle changes and changes in bone density over two years. This study will lead to accurate information about how best to target osteoporosis prevention programs in the younger age groups. Furthermore, as risk factors for cardiovascular and other diseases are often similar to those for osteoporosis, it is likely to provide insights into the prevention of these diseases and, as a result, have much greater potential for decreasing disease in the community.