title: Population screening for low bone mineral density: do non-attenders have a lower risk of osteoporosis?
abstract: Poor compliance may be detrimental to the effectiveness of a screening programme if those at greatest risk of the disease do not attend. Therefore we undertook a study to test whether non-attenders to a screening programme for low bone density, a risk factor for osteoporosis, were at a differential risk of low bone density compared with attenders. Seven hundred and eighty-nine women aged 45-49 years living within 32 km of Aberdeen were selected at random from the Community Health Index and invited to attend for screening for low bone density as a risk of factor for osteoporosis. Attenders and non-attenders were surveyed regarding their risk factors for osteoporosis. Non-attenders were significantly heavier than attenders. In addition, 6 non-attenders who subsequently chose to attend had significantly higher body weight and bone mineral density, at Ward's triangle, than initial attenders. Non-attenders to a screening service for bone density may be at lower risk of developing osteoporosis. Non-attendance, therefore, would not be detrimental to the cost-effectiveness of a screening service for bone density. However, this study indicates there is a potential for response bias in studies of bone density and osteoporosis.
authors.affiliation: Health Economics Research Unit, University of Aberdeen, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Torgerson
authors.forename: C
authors.initials: C
authors.lastname: Donaldson
authors.forename: M J
authors.initials: MJ
authors.lastname: Garton
authors.forename: I T
authors.initials: IT
authors.lastname: Russell
authors.forename: M
authors.initials: M
authors.lastname: Westland
authors.forename: D M
authors.initials: DM
authors.lastname: Reid
mesh_terms: D015982:Bias; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology / Q000517:prevention & control*; D010349:Patient Compliance; D012307:Risk Factors