Non-participation in systematic screening for osteoporosis-the ROSE trial.

Area of Science:

• Gerontology
• Public Health
• Medical Screening

Background:

• Population-based screening for osteoporosis remains controversial and lacks widespread implementation.
• Understanding non-participation is key to improving the success of screening programs.

Purpose of the Study:

• To analyze non-participation in a two-step, population-based osteoporosis screening program called Risk-stratified Osteoporosis Strategy Evaluation.
• To identify factors associated with non-completion of questionnaires and non-acceptance of DXA scans.

Main Methods:

• 34,229 women aged 65-81 were randomized to screening or control groups.
• A questionnaire assessing fracture risk (FRAX) was administered, followed by DXA scans for high-risk individuals.
• Data on socioeconomic status and comorbidity were obtained from national registers.

Main Results:

• Questionnaire completion rate was 61%; non-completion was associated with older age, living alone, lower education/income, and higher comorbidity.
• Declining DXA was linked to older age, living alone, and low perceived fracture risk.
• Women with prior fractures or parental hip fracture history were more likely to accept DXA.

Conclusions:

• Barriers to osteoporosis screening are psychosocial and physical, affecting older women with lower perceived risk and those living alone.
• Dropping out is associated with aging, physical impairment, smoking, and alcohol consumption.
• Targeted information and reduced physical barriers are recommended to increase participation.