Most people associate osteoporosis with women. But the truth is, one in four men over the age of 50 will break a bone as a result of this condition. That's more men than will have prostate cancer, according to the National Osteoporosis Foundation.

A new paper is calling for men to be included in the screening guidelines for osteoporosis while the government is trying to do even less testing to reduce the runaway costs incurred after the Affordable Care Act.

Elizabeth Regan, MD, PhD, a researcher at National Jewish Health, studied more than 3,000 smokers and former smokers ages 45 to 80 and tested their bone density and says the results point to the need for the U.S. Preventive Services Task Force, which last updated osteoporosis screening guidelines in 2011, to consider adding at-risk men to their screening guidelines, which now include only women. 

"We actually found that men were slightly more likely to have low bone density, and that they were slightly more likely to have vertebral fractures," said Dr. Regan. "In fact, 60 percent of the men had vertebral fractures compared to 40 percent of the women, while 55 percent of men had low bone density compared to 45 percent of women.

"I think that a sizable number of men who have low bone density are not getting diagnosed, and they're not getting treated. And so they're sustaining fractures that they could avoid. We need to change that." 

Dr. Regan says that the screenings could be either the standard bone density scan or a CT scan, which is sometimes used to screen heavy smokers for cancer. Former rancher Gary Hunter agrees. The 62-year-old suffers from Chronic Obstructive Pulmonary Disease (COPD) and snapped a vertebra while picking up an oxygen tank that weighed only a few pounds. He was shocked to learn that his broken back was caused by osteoporosis. "I've been active all my life. I've broken bones before, but never doing a simple task like that. I never dreamed that could happen to me," said Hunter.

Mehrnaz Maleki, MD, a rheumatologist at National Jewish Health, says that proper screening is essential, because many times a diagnosis of osteoporosis comes as a surprise. "Normally osteoporosis does not have any signs, which is the problem. You might not have any pain or other signs that something might be wrong," she said.

Dr. Maleki has these tips for osteoporosis prevention for both men and women:

1. Take a calcium supplement.

2. Take a vitamin D supplement, or spend 20 minutes outside every day to absorb sunshine, which boosts vitamin D levels.

3. Eat a healthy diet rich in calcium.

4. Stay active, especially with weight-bearing exercises.

5. Don't smoke.

6. Don't drink alcohol in excess.