Osteoporosis: the silent killer. We need a national programme

n Ireland, there is no national DXA registry or osteoporosis screening program. This lack of structured screening leads to ineffective practices, with unnecessary testing of young, healthy adults and many at-risk individuals going undiagnosed. Over-diagnosis can be just as harmful as under-diagnosis, resulting in mismanagement and resource waste. Additionally, no comprehensive DXA dataset exists for Ireland, and the most widely used risk prediction tool, web FRAX, shows significant inaccuracies for Irish people when bone mineral density (BMD) is not included.

If no changes are made, people in Ireland will continue to suffer from undetected and untreated osteoporosis. Currently, 80% of Irish fracture care patients are neither screened nor treated for osteoporosis, despite the fact that Ireland has the highest mortality rate following osteoporosis-related hip fractures in the year after an incident. Half of all women and 20-25% of men over 50 will experience an osteoporosis-related fracture, and more than 50% of those women remain untreated despite being at high risk. Without targeted, effective screening, the health and quality of life of a significant portion of the population remain at risk.

The urgency to act is clear: osteoporosis is a major global health issue, affecting over 200 million people worldwide, and the evidence shows that screening can reduce fracture risk. Every 30 seconds, someone in the EU suffers an osteoporotic fracture. In Ireland, without effective screening tools and strategies, we are failing those who need support most. The time for action is now, as delays in diagnosis and treatment only increase the risks, costs, and suffering associated with this disease.

We need a national DXA registry and a national osteoporosis screening programme. Greater investment needs to be made into spreading awareness of the condition. Ireland needs to close the gap in osteoporosis screening and provide at-risk individuals with the care they need before fractures occur.