Women are commonly screened for osteoporosis at age 65 years. How should screening for osteoporosis be managed in a male this age?

• A. They should be screened starting at age 65 if they have risk factors.
• B. They should be screened routinely at age 65.
• C. They do not need screening since this is not prevalent in males.
• D. They should be screened if they have prostate disease.

Answer: (A)

The main idea is that osteoporosis screening in men at age 65 is not done routinely for all men; it’s recommended when there are risk factors that raise fracture risk. Men do develop osteoporosis, and age increases fracture risk, but universal screening at 65 isn’t the standard. If a 65-year-old man has risk factors—such as a prior fragility fracture, chronic glucocorticoid use, low body weight, hypogonadism or low testosterone, smoking, heavy alcohol use, or certain chronic diseases—the next step is to perform bone density testing (DXA) and assess fracture risk (often with FRAX). This targeted approach helps identify those who would benefit from treatment to prevent fractures. Prostate disease by itself isn’t a screening trigger; however, therapies for prostate cancer that reduce testosterone can increase bone loss, which would then influence screening decisions.