Incidence And Risk Factors For Low Trauma Fractures In Men With Prostate Cancer

Publisher:
Elsevier Science Inc
Publication Type:
Journal Article
Citation:
Bone, 2008, 43 (3), pp. 556 - 560
Issue Date:
2008-01
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Background: Men with prostate cancer on androgen deprivation therapy (ADT) are at increased risk of bone loss. The present study sought to determine the incidence of low trauma fracture in men with prostate cancer (PC), and to characterize the association between potential risk factors and fracture risk in these men. Methods: In the prospective, population-based Dubbo Osteoporosis Epidemiology Study, 43 men aged 60+ years reported a history of prostate cancer; among whom, 22 men received ADT, and 21 men did not. Low-trauma fractureswere ascertained between 1989 and 2004. Bone mineral density at the femoral neck (FNBMD), postural instability and lifestyle factors were obtained at baseline. Results: Men with prostate cancer had significantly higher lumbar spine BMD than those without cancer (p=0.013). During the follow-up period, 15 men with prostate cancer had sustained a fracture, yielding the ageadjusted incidence of fracture among this group was 31.6 per 1000 person-years, which was greater than those without cancer (22.1 per 1000 person-years). The age-adjusted incidence of fracture was more pronounced among those with prostate cancer on ADT (40.2 per 1000 person-years). After adjusting for age, the increase in fracture risk among prostate cancer patientswas associated with lower femoral neck BMD (hazard ratio [HR] per SD=1.8, 95% CI: 1.03.4) and increased rate of bone loss (HR 2.3, 1.24.6). Conclusions: Menwith prostate cancer, particularly those treated with ADT, had an increased fracture risk. Although the average BMD inmen with prostate cancerwas higher thanmen without cancer, a lowBMDprior to treatment or increased rate of bone loss after initiating ADT treatment was each a significant predictor of fracture in these.
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