Who gets osteoporosis in Canada, how it's diagnosed, what screening tools are available, and how provincial health plans cover bone density testing.
Osteoporosis is often called a "silent disease" because bone loss happens without symptoms — until a fracture occurs. By the time someone breaks a hip or vertebra, the underlying problem has often been developing for decades. Understanding the scope of the problem in Canada, and knowing whether you're at risk, is the first step toward doing something about it.
According to Osteoporosis Canada, approximately 2.3 million Canadians have osteoporosis, and an estimated 80% of fractures in people over 50 are linked to low bone density. This makes it one of the most common chronic diseases in the country — more prevalent than heart attack, stroke, and breast cancer combined among women over 50.
Despite these numbers, osteoporosis remains significantly under-diagnosed and under-treated. Osteoporosis Canada estimates that fewer than 20% of patients who suffer a fragility fracture receive appropriate follow-up care or investigation for underlying bone disease.
Osteoporosis risk isn't simply about age. It's the product of how much bone mass you accumulated in your youth (peak bone mass, usually reached in your late 20s) and how quickly you lose it over time. Several factors influence both sides of that equation.
It's worth noting that osteoporosis in men is often overlooked. While it's more common in women, one in five men over 50 will experience an osteoporotic fracture. Hip fractures in men carry a higher mortality rate than in women — approximately 37% of men who fracture a hip die within one year.
The FRAX tool, developed by the World Health Organization and available at sheffield.ac.uk/FRAX, calculates your 10-year probability of a major osteoporotic fracture (hip, spine, forearm, shoulder) based on your clinical risk factors. A Canadian version of FRAX is available and uses Canadian epidemiological data.
FRAX can be calculated with or without a bone density scan result — it's a useful starting point even if you haven't had a DEXA scan. Your physician can use FRAX results to determine whether treatment is warranted and to prioritize who gets referred for bone density testing.
The Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool is another option used by Canadian clinicians — it integrates DEXA results with clinical risk factors to provide a 10-year fracture risk as low, moderate, or high. Ask your doctor which tool they use.
Osteoporosis Canada's 2010 Clinical Practice Guidelines recommend bone mineral density (BMD) testing for:
If you're not sure whether you should be screened, the Osteoporosis Canada website has a simple risk assessment tool worth taking before your next physician visit.
DEXA (dual-energy X-ray absorptiometry) is the gold standard for measuring bone mineral density. It's a low-radiation, non-invasive scan — about 10 minutes — that measures bone density at the hip and lumbar spine. Here's a general overview of coverage by province (coverage criteria change; always confirm with your provincial health plan):
| Province | Coverage Notes |
|---|---|
| British Columbia | Covered by MSP for women 65+ and those with risk factors. Requires physician referral. |
| Alberta | AHCIP covers DEXA with risk factors or prior fracture; age-based eligibility at 65+. |
| Ontario | OHIP covers for women 65+ and for both sexes with specific clinical indications. |
| Quebec | RAMQ covers with clinical indications including fragility fracture, steroid use, and risk factors in women 65+. |
| Manitoba | Manitoba Health covers with physician referral and established risk criteria. |
| Saskatchewan | Saskatchewan Health covers with risk factors present and physician referral. |
| Atlantic Provinces | Nova Scotia, New Brunswick, PEI, and Newfoundland cover with risk factors; eligibility varies. Check with your provincial plan. |
If you don't meet provincial coverage criteria but want a baseline scan, private DEXA is available at many radiology clinics and some family health clinics in major Canadian cities, typically ranging from $75–$175 out of pocket.
If osteoporosis or osteopenia (low bone density that hasn't yet reached the osteoporosis threshold) is diagnosed, treatment depends on fracture risk. Not everyone with low bone density needs medication — lifestyle changes (calcium, vitamin D, weight-bearing exercise) are the foundation at all levels of risk.
For those at moderate to high fracture risk, first-line medications in Canada include:
These medications require prescription and monitoring. If you've had a fragility fracture, Osteoporosis Canada recommends asking your doctor specifically about your fracture risk — you're more likely to need treatment than a same-aged person who hasn't fractured, regardless of your DEXA T-score.
See our full guide to understanding osteoporosis and our supplements guide for practical nutrition and supplementation recommendations.