TempoLife › Ominaisuudet › Health screening by age: which test and when › bone-density
Bone density and fracture risk
Nobody is invited for a DXA scan. The route in is a fracture risk score, and the single most reliable trigger is a bone broken from a fall that should not have broken anything.
This page describes screening programmes; it is not a diagnosis, not a personal risk assessment and not a substitute for your own health service. Age bands are set nationally and change — the invitation you receive, and the body named on your country page, outrank anything written here. Screening is for people without symptoms: a new lump, blood you can see, a mole that has changed, unexplained weight loss or a sudden change in vision or hearing needs a clinician now, whatever a recent screening result said.
Where it is organised
Nowhere in this region as an invitation programme. That is a decision rather than an oversight, and the section below explains the reasoning. It also means nothing will arrive in the post: if this is something you want checked, you have to ask for it.
What the scan measures and what the number means
Dual-energy X-ray absorptiometry scans the hip and lower spine with a very low radiation dose, and reports a T-score: how far your bone density sits from that of a healthy young adult, in standard deviations. Minus 2.5 or below is the World Health Organization definition of osteoporosis. Between minus 1.0 and minus 2.5 is the intermediate band, often called osteopenia, which is a statistical description rather than a disease. It is important to understand that the T-score is one input into fracture risk, not the whole of it: age, previous fracture, parental hip fracture, smoking, alcohol, steroid use and rheumatoid arthritis all carry independent weight, which is why risk calculators exist.
Why there is no invitation programme
Bone density on its own is a mediocre predictor of who will break a hip, and a screening programme built on scanning everybody would scan a great many people who would never fracture while missing high-risk people whose density is unremarkable. The approach used across the region instead is to estimate absolute fracture risk from clinical factors, and to send for a scan the people whose estimated risk sits near a treatment threshold — where the extra information will actually change a decision. It is a good example of a test that is genuinely useful but a poor screening instrument.
The fracture that should trigger everything
A fragility fracture is a bone broken by a force that should not have broken it: a fall from standing height onto a wrist, a hip, a shoulder, or a vertebra that quietly collapses and shows up as height loss and a stooped back. It is the strongest single predictor of the next fracture, and it is missed constantly — the wrist is plastered, the patient goes home, and nobody asks why a wrist broke at sixty-five. If you or a parent has had one, that is the moment to ask about bone health explicitly. Height loss of several centimetres and a new curve in the upper back are the quiet version of the same signal.
What actually protects bone
Loading and nutrition, and neither is exotic. Bone responds to impact and to resistance: walking, stair climbing, jumping where joints allow it, and progressive strength training all stimulate it, while swimming and cycling — excellent for other things — do not load bone much. Adequate protein and calcium matter, and vitamin D matters more at this latitude than almost anywhere, because the winter sun in the Nordic and Baltic countries is too low to make any. Beyond that, the most effective fracture prevention in an older person is often not about bone at all: balance training, a review of medicines that cause dizziness, an eye test, and removing the rug at the top of the stairs.
Sources: World Health Organization diagnostic criteria for osteoporosis (T-score −2.5) · FRAX fracture risk assessment tool, University of Sheffield · checked 2026-09-07
Usein kysytyt kysymykset
Is anyone invited for a bone density scan?
No. There is no invitation programme anywhere in the region. Scans are arranged when a fracture risk assessment, a fragility fracture or a specific risk factor makes the result likely to change a decision.
What does a T-score of −2.5 mean?
It is the World Health Organization threshold for osteoporosis: bone density two and a half standard deviations below that of a healthy young adult. Between −1.0 and −2.5 is the intermediate band, which describes a statistic rather than a disease.
What is a fragility fracture?
A bone broken by a force that should not have broken it — typically a fall from standing height, or a vertebra that collapses and shows as height loss and a stooped back. It is the single strongest predictor of the next fracture and it is very often not followed up.
What exercise is good for bones?
Impact and resistance: walking, stair climbing, jumping where joints allow, and progressive strength training. Swimming and cycling are excellent exercise but do not load bone. Balance work matters as much, because most fractures start with a fall.
The rest of the surface
Breast cancer screening (mammography)
An X-ray of each breast, read by two radiologists, repeated every two years across a band of ages that starts at 40 in Sweden and 50 almost everywhere else. What it finds, what it misses and what a call-back means.
Cervical screening (HPV test)
Almost every country in the region has switched from looking for abnormal cells to looking for the virus that causes them. The test is better, so the gap between tests is longer — and in several countries you can now take the sample yourself.
Bowel cancer screening (stool test)
A sample from one bowel movement, taken at home and posted. It is the only screening programme in the region that routinely prevents cancers rather than only finding them early — because the follow-up removes the polyp.
Prostate screening (PSA)
Latvia and Lithuania fund PSA testing for men in their fifties and sixties. Sweden assessed the same evidence and recommends against an organised programme. Here is what the trials actually found.
Lung cancer screening (low-dose CT)
The trials are positive and the European recommendation asks countries to build programmes stepwise. In this region it is still pilots rather than invitations — but the eligibility rule is worth knowing.
What screening can and cannot do
Overdiagnosis, false positives, interval cases and lead-time bias — the four ideas behind every disagreement between countries.
All 27 screening pagesIf the result is not normal
The record that makes the appointment shorter
TempoLife keeps weight, blood pressure, sleep and symptoms in one place, so the questions you get asked at a screening appointment already have answers.