Osteoporosis is a systemic skeletal disease characterized by low bone mass and deterioration of the fine structures of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Although studied mainly in postmenopausal women, osteoporosis has been recognized as a prevalent disease in men through similar mechanisms (ie, age-related bone loss, hormonal alterations, and other conditions/risk factors associated with bone loss). However, larger bone size, later onset of increased bone resorption, and lower fall risk are protective factors in men leading to a lower lifetime risk of fracture: 53.2% among women versus 20.7% among men. Despite a lower risk of fracture, for unclear reasons, men have higher rates of osteoporotic fracture-related complications and mortality than women.

Contents

• PREFACE
• ACKNOWLEDGMENTS
• EXECUTIVE SUMMARY
  • INTRODUCTION
  • METHODS
  • RESULTS
  • DISCUSSION
• INTRODUCTION
  • Key Questions
• METHODS
  • TOPIC DEVELOPMENT
  • SEARCH STRATEGY
  • STUDY SELECTION
  • DATA ABSTRACTION
  • QUALITY ASSESSMENT
  • DATA SYNTHESIS
  • RATING THE BODY OF EVIDENCE
  • PEER REVIEW
• RESULTS
  • LITERATURE FLOW
  • EVIDENCE PROFILE
  • ORGANIZATION OF RESULTS
  • KEY QUESTION 1. Among males not identified by a history of low-trauma fracture, is there a clinical risk tool (eg, FRAX) that identifies patients at highest risk of osteoporosis or major osteoporotic fracture?
  • QUALITY OF EVIDENCE FOR KEY QUESTION 1
  • KEY QUESTION 2. Among male Veterans not identified by a history of low-trauma fracture, is there a tool or combination of risk factors that identify patients at highest risk of osteoporosis or major osteoporotic fracture?
  • QUALITY OF EVIDENCE FOR KEY QUESTION 2
  • KEY QUESTION 3. What system-level interventions improve uptake of osteoporosis screening among people not identified by a history of low-trauma fracture?
  • QUALITY OF EVIDENCE FOR KEY QUESTION 3
• SUMMARY AND DISCUSSION
  • SUMMARY OF EVIDENCE BY KEY QUESTION
  • PRIOR SYSTEMATIC REVIEWS
  • CLINICAL POLICY IMPLICATIONS
  • LIMITATIONS
  • RESEARCH GAPS/FUTURE RESEARCH
  • CONCLUSIONS
• REFERENCES
• APPENDIX A. SEARCH STRATEGIES
• APPENDIX B. KQ 1 AND KQ 2 STUDY CHARACTERISTICS TABLE
• APPENDIX C. KQ 3 STUDY CHARACTERISTICS TABLE
• APPENDIX D. KQ 1 AND KQ 2 EXCLUDED STUDIES
• APPENDIX E. KQ 3 EXCLUDED STUDIES
• APPENDIX F. PEER REVIEW COMMENTS
• APPENDIX G. TOOLS

Suggested citation:

Sagalla N, Alexopoulos AS, Gordon AM, et al. Screening for Male Osteoporosis: A Systematic Review. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #09-010; 2022.

This report was prepared by the Evidence Synthesis Program Coordinating Center located at the Durham VA Medical Center, Durham, NC, directed by Jennifer M. Gierisch PhD, MPH and Karen M. Goldstein, MD, MSPH and funded by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development.

The findings and conclusions in this document are those of the author(s) who are responsible for its contents and do not necessarily represent the views of the Department of Veterans Affairs or the United States government. Therefore, no statement in this article should be construed as an official position of the Department of Veterans Affairs. No investigators have any affiliations or financial involvement (eg, employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in the report.