La prévention de l'ostéoporose et ses incidences économiques

Osteoporosis is a skeletal disease which deteriorates bone tissue and lowers its density. Bone fragility induces fractures of the hip, vertebrae and distal radius. These fractures occur mainly to women after their menopause due to important postmenopausal changes in bone metabolism. Osteoporosis and related fractures are a major public health issue, as the upcoming population aging will sharply increase their incidence. For the time being prevention of osteoporosis is at a crossroads in France. One way would be to treat the entire post-menopause female population with hormone substitution to avoid the incidence to one third among them : the cost would be very high and, for the time being, the risk benefit ratio is not well known (we do not know the risks of a treatment lasting 20 or 25 years). The other way would be to implement only reliable diagnostic programs without generalized hormone treatment : such an option might lead to a sharp increase of the disease incidence, causing a high cost both in social and financial terms