The UK National Screening Committee (UK NSC) has opened a consultation on evidence relating to screening for osteoporosis in women.
Osteoporosis is one of the health conditions the committee reviews regularly for evidence relating to population screening. The UK NSC currently does not recommend screening for osteoporosis in postmenopausal women, based on a 2019 review of the evidence.
An evidence map was commissioned to review literature on the topic published since the previous 2019 review. Evidence maps are typically the first step in the UK NSC process of reviewing evidence. They help decide whether a more in-depth review is needed.
Following the completion of the evidence map in 2025, an ‘umbrella review’ was commissioned. Also known as a ‘review of reviews’, an umbrella review brings together findings from multiple systematic reviews on the same topic and assesses how reliable the evidence is.
This umbrella review has now been completed. It concludes there is currently insufficient evidence, in both quality and quantity, to support the implementation of either population or targeted screening for osteoporosis in adult women. It is likely this conclusion could only be reconsidered if new evidence becomes available from primary research trials.
The UK NSC has also worked with the National Institute for Health and Care Excellence (NICE) to clarify that NICE guidance supports individual clinical care, while the UK NSC advises on population-level screening programmes. See joint statement by NICE and UK NSC below.
We have opened a public consultation to ask individuals and organisations to provide feedback on the findings and conclusions of both the 2025 evidence map and the 2026 umbrella review.
How to respond
To take part in the consultation, download the consultation documents by clicking on the grey ‘View documents’ button on the UK NSC’s Osteoporosis recommendation page. Then submit your response by clicking on the green ‘Submit comments’ button.
The deadline for responses is 11.59pm GMT on 7 October 2026.
About osteoporosis
Osteoporosis is a condition that weakens the bones, making them thinner and more likely to break. It is a major health concern for women after the menopause, and the risk of fracture increases sharply with age. Bone strength usually peaks in early adulthood and then gradually declines over time. After the menopause, this loss of bone strength can happen more quickly.
Fragility fractures are commonly associated with osteoporosis. Fragility fractures occur after a minor fall or injury and may affect sites such as the hip, spine, or wrist. Hip fractures are particularly serious because they are associated with significant disability, loss of independence, and increased risk of death, especially among older people.
The 2025 evidence map
The 2025 evidence map identified one new trial and 5 systematic reviews since the 2019 review assessing the benefits of population screening among women over 65 years of age. In addition, some previously identified trials had published updated findings with extended follow-up.
However, the systematic reviews reached mixed conclusions, despite overlap in the included studies. Some reported small but meaningful reductions in fractures, while others found little or no benefit of screening. Evidence remained limited on targeted screening in women and the cost effectiveness of osteoporosis screening.
The 2026 umbrella review
To explore the mixed conclusions of the systematic reviews identified in the 2025 evidence map, the umbrella review updated the literature search and examined the included primary trials and systematic reviews. It found that differences in review conclusions largely reflected variations in interpretation of trial evidence rather than conflicting results.
Screening women aged 65 and over might slightly reduce the incidence of hip fractures, but the evidence is uncertain because of study quality concerns and uncertainty about whether the findings would translate into routine screening practice. In addition, differences in how the trials were designed, how participants were recruited, and how screening was delivered, make it difficult to apply the findings directly to any potential screening approach. Overall, there is still limited and potentially biased evidence to support screening.
Based on the findings of the evidence map and umbrella review, no further evidence synthesis work on population or targeted screening for osteoporosis in women should be commissioned at the present time. More research is needed and should be encouraged to address the current evidence gaps. Targeted screening may be a more immediate research priority. Trials should use approaches that could be delivered in routine practice.
NICE and UK NSC joint statement
NICE has published guidance on assessing the risk of osteoporosis in men and women including those at higher risk. NICE is updating this guidance following a recent consultation exercise and expects to publish the updated guidance at the end of July 2026.
The UK NSC and NICE work closely together and meet regularly to discuss areas of overlap, including on specific topics such as osteoporosis. To support a clear understanding of the respective roles of each organisation, NICE and the UK NSC have agreed the following clarifications:
- the introduction of population-level screening programmes falls outside the remit of NICE guidelines
- NICE guidelines recommendations are primarily intended to support decision-making in individual patient care
- the UK NSC advises ministers and the NHS on national screening programmes, which are proactively offered to people without symptoms and/or not currently engaged with health services
- because of the different contexts, the evidence needed for clinical guidance is not the same as the evidence needed to justify the recommendation and implementation of a nationally delivered screening programme
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