Merlijn T, Swart KMA, van Schoor NM, et al. - A total of 11,032 women aged 65–90 years with ≥ 1 clinical risk factor for fractures were randomized to screening (n = 5,575) or usual care (n = 5,457) by the experts in order to examine whether screening for fracture risk and subsequent treatment in primary care could decrease fractures compared with usual care. Among those in the screening group, 1,417 had an indication for anti-osteoporosis treatment. Screening and subsequent treatment had no statistically notable impact on the primary outcome fracture, nor on the secondary outcomes osteoporotic fractures, major osteoporotic fractures, hip fractures, falls or mortality. According to post hoc explorative findings, screening may be most efficient following a recent fracture. Therefore, in the screening group, the outcomes of this study might have been compromised by nonparticipation and medication nonadherence. Overall, this study did not support screening for fracture prevention. Nevertheless, its clinical significance to decrease (major) osteoporotic fractures and hip fractures should not be ignored due to the relatively small number of women with a treatment indication in the intervention group.