Analysis of DXA use for the 50+ age group in denmark 2010-2022: successful targeting to persons at high risk of fracture?

Hansen Benjamin Bakke; Rubin Katrine Hass; Bryan Haddock; Lars Folkestad; Bente Langdahl; Pia Eiken; Wiil Uffe K; Peter Vestergaard; Bo Abrahamsen

doi:10.1530/endoabs.109.P69

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Endocrine Abstracts (2025) 109 P69 | DOI: 10.1530/endoabs.109.P69

SFEBES2025 Poster Presentations Bone and Calcium (25 abstracts)

Analysis of DXA use for the 50+ age group in denmark 2010-2022: successful targeting to persons at high risk of fracture?

Benjamin Bakke Hansen ^1,2 , Katrine Hass Rubin ^1,2 , Bryan Haddock ³ , Lars Folkestad ⁴ , Bente Langdahl ⁵ , Pia Eiken ⁶ , Uffe K Wiil ⁷ , Peter Vestergaard ⁸ & Bo Abrahamsen ^1,9

Author affiliations

¹OPEN, Faculty of Health, University of Southern Denmark, Odense, Denmark; ²OPEN, Odense University Hospital, Odense, Denmark; ³Clinical Imaging, Danish National Hospital Rigshospitalet, Copenhagen, Denmark; ⁴Endocrinology, Odense University Hospital, Odense, Denmark; ⁵Endocrinology, Aarhus University Hospital, Aarhus, Denmark; ⁶Endocrinology, Bispebjerg Hospital, Copenhagen, Denmark; ⁷The Maersk Mc-Kinney Moller Institute, SDU, Odense, Denmark; ⁸Steno Diabetes Centre, Aalborg University Hospital, Aalborg, Denmark; ⁹Medicine, Holbæk Hospital, Holbæk, Denmark

Background: DXA is a resource with waiting lists and limited capacity and there are concerns that significant capacity may be used in repeated assessment of people at low immediate risk of osteoporotic fractures. Danish guidelines recommend DXA in individuals above 50 with at least one clinical risk factor, including for example family history. The strongest predictors of fracture risk are age, sex, fracture history and glucocorticoid (GC) use. As the first step in establishing our national BMD research resource, we aimed to describe DXA usage over the past decade.

Methods: We obtained patient level data on DXA utilisation, fractures, and GC use from national Danish registers in persons aged 50+ as of 2010 and used a 5y look-back to identify prior DXA exams to classify DXAs as ‘primary’ or follow-up. Prior major osteoporotic fractures (MOF) in the preceding five years were retrieved from in- and outpatient contacts.

Results: Out of 896,538 DXA visits (Table 1), 48% were primary exams. Women accounted for 76% of primary exams and 84% of follow-up exams. The majority of exams were in people under 75 years of age. Among primary DXA visits, 32% were strongly justified by MOF or GC use. However, almost half of DXA visits were in non-GC users under 75 years of age without MOF. A declining trend in N of very short interval DXA (low value 90 days, 180 days) was observed (data not shown).


Calendar years 2010-2022	Primary DXA	Follow-up DXA
N of visits	506,330	390,208
Age	70.9 +- 8.9	72.4 +- 8.0
Age >75	164,576 (32.5%)	144,829 (37.1%)
Prior Major Ost Fx (5y)	74,588 (14.7%)	56,073 (14.4%)
Prior GC exposure (1y)	96,063 (19.0%)	65,949 (16.9%)

Conclusion: Initiatives to improve case-finding and reduce the need for follow-up DXA are needed to improve targeting of DXA to those at the greatest need.