Dual-energy x-ray absorptiometry to screen for osteoporosis is both underused in women who meet the U.S. Preventive Services Task Force criteria for screening, and overused in low-risk younger women, new data suggest.

A retrospective, longitudinal cohort study of 50,995 women attending 13 primary care clinics found that among previously unscreened women who met the criteria for screening, the 7-year cumulative incidence of DXA screening ranged from 58.8% in women aged 60-64 years with at least one risk factor, to 42.7% in women aged 75 years and older.

But among women who didn’t meet screening criteria, the 7-year cumulative incidence was 45.5% in women aged 50-59 years and 58.6% in women aged 60-64 years without risk factors, according to a paper published May 19 in the Journal of General Internal Medicine ( doi:10.1007/s11606-015-3349-8 ).

The U.S. Preventive Services Task Force currently recommends screening for osteoporosis with DXA for women aged 65 and older, as well as young women at increased risk for fracture. The American Academy of Family Physicians also advised against DXA screening in women younger than age 65 without osteoporosis risk factors as part of the “Choosing Wisely” campaign.

“Additional research is needed to elucidate patient, physician, and health system barriers to evidence-based screening so that interventions can maximize the value of population screening for osteoporosis,” wrote Dr. Anna Lee D. Amarnath of the University of California, Davis Health System, and her coauthors.

The study was supported by the National Institutes of Health and the Agency for Healthcare Research and Quality. The researchers reported having no financial disclosures.