"Community screening for osteoporosis could prevent more than a quarter of hip fractures in older women according to new research. A new study published in The Lancet has shown that a simple questionnaire combined with bone mineral density measurements for some would help identify those at risk of hip fracture. The research involving more than  older women and carried out in collaboration between the universities of Birmingham East Anglia Bristol Leicester York and Sheffield found that screening through GP practices allowed patients to be targeted for treatment. In women agreeing to participate this led to a  per cent reduction in hip fractures over five years. Professor Neil Gittoes of the University of Birminghams Institute of Metabolism and Systems Research said Our findings showed that screening led to a statistically significant decrease in hip fractures. Our data has the potential to influence national policies around prevention of hip fractures which is particularly relevant in our ageing society. The consequences of hip fractures to older people can be devastating including impaired mobility and loss of independence. While we have demonstrated clinical effectiveness of screening we are also exploring costeffectiveness of this approach initial analyses also look promising in this respect. Professor Lee Shepstone from UEAs Norwich Medical School said Approximately one in three women and one in five men aged over  year will suffer a fragility fracture during their remaining lifetime. In the UK around  people suffer fragility fractures each year including  hip fractures.  A hip fracture can be devastating with a loss of independence and less than one third of patients make a full recovery. Mortality at oneyear postfracture is approximately  per cent. We wanted to find out whether screening like screening for breast cancer could help identify those at risk of suffering a fracture. The team used a University of Sheffield developed tool called FRAX which predicts the probability of a hip fracture or a major osteoporotic fracture a hip spine upper arm or lower arm fracture to identify older women at high risk. A total of  women aged  were recruited from  GP practices in seven regions Birmingham Bristol Manchester Norwich Sheffield Southampton and York. Half of the women were screened to compare screening with routine care. Among those screened treatment was subsequently recommended for one in seven women deemed at high risk of hip fracture. This recommendation was acted upon by the women and their GPs so that over three quarters of the women at high risk were on osteoporosis medications within six months of screening.  While screening did not reduce the incidence of all osteoporosisrelated fractures there was strong evidence for a reduction in hip fractures.  In the screening group there were  fewer women who suffered one or more hip fractures compared to the routine care group.  The study suggests that one hip fracture could be prevented for every  women screened and early analysis suggests the approach is likely to be costeffective. Professor Shepstone added This is the first trial to show that a communityscreening approach based on the FRAX fracture risk tool is both feasible and effective. Given that the number of costly and debilitating hip fractures are expected to increase with an ageing population the results of this study potentially have important public health implications.  Professor Eugene McCloskey of the University of Sheffield said Lowcost screening with FRAX among the older population could result in effective targeted intervention to reduce the human and socioeconomic burden of hip fractures.  If the SCOOP screening strategy was taken up in exactly the same way as in the study in all UK women aged  years we estimate that the strategy could prevent up to  hip fractures per year in the UK. Even greater gains could be made if we could reach out to women similar to those who did not take part in the study.  The randomised controlled trial SCreening for Osteoporosis in Older women for the Prevention of fracture SCOOP was funded by the Medical Research Council and Arthritis Research UK. Dr Natalie Carter head of research liaison and evaluation at Arthritis Research UK said Ten of thousands of people a year present with hip fractures in the UK. As well as significantly increasing mortality a hip fracture can stop a persons ability to live independently with  no longer being able to walk independently in the year after the fracture. We welcome this community based screening programme and any other research that reduces the likelihood of fractures.  For further information or interviews contact Emma McKinney Press Office University of Birmingham at     or contact the Press Office out of hours on . NOTES TO EDITORS  The University of Birmingham is ranked amongst the worlds top  institutions. Its work brings people from across the world to Birmingham including researchers teachers and more than  international students from over  countries.  Shepstone et al . Screening in the community to reduce fractures in older women SCOOP a randomised controlled trial. The Lancet.  Read the paper here http http  FRAX is a simple calculation tool that integrates clinical information in a quantitative manner to predict a year probability of major osteoporotic fracture for both women and men in different countries. The tool launched by the then WHO Collaborating Centre for Metabolic Bone Diseases in  was developed at the Centre for Metabolic Bone Diseases University of Sheffield UK in collaboration with international researchers. It assists primary healthcare providers to better target people in need of interventions to reduce fracture risk thus improving the allocation of healthcare resources towards patients most likely to benefit from treatment. The FRAX calculator is now freely available for  countries and in  languages.  The International Osteoporosis Foundation IOF is the worlds largest nongovernmental organization dedicated to the prevention diagnosis and treatment of osteoporosis and related musculoskeletal diseases. IOF members including committees of scientific researchers as well as  patient medical and research societies in  locations work together to make fracture prevention and healthy mobility a worldwide heath care priority.   Arthritis Research UK invests in breakthrough treatments the best information and vital support for everyone affected by arthritis. We believe that by harnessing the power of exceptional science we can overcome the pain isolation and fatigue arthritis causes making everyday life better for all  million people with arthritis in the UK.   Researchers involved in this study are affiliated to the following School of Medicine University of East Anglia Norwich UK  Norfolk and Norwich University Hospital Norwich UK  Bristol Medical School University of Bristol Bristol UK  Department of Rheumatology University Hospitals Bristol Bristol UK  Medical Research Council Lifecourse Epidemiology Unit University of Southampton Southampton General Hospital Southampton UK  College of Medical and Dental Sciences University of Birmingham UK  Centre for Endocrinology Diabetes and Metabolism Queen Elizabeth Hospital Birmingham UK  Leicester Medical School Centre for Medicine University of Leicester UK  National Institute of Health Research Manchester Musculoskeletal BRU Central Manchester University Hospitals NHS Foundation Trust   Arthritis Research UK Centre for Epidemiology University of Manchester Manchester UK  Department of Health Sciences University of York York UK  Centre for Metabolic Bone Diseases University of Sheffield Sheffield UK  Mellanby Centre for Bone Research Centre for Integrated Research into Musculoskeletal Ageing University of Sheffield Sheffield UK  Australian Catholic University Melbourne VIC Australia"