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Beyond The Abstract - Fracture Risk In Danish Men With Prostate Cancer: A Nationwide Register Study

UroToday.com - The strength of this study is that it covers all fractures at the national level. This was made possible by robust Danish health registers with long term coverage (back to 1977) and information on all prescriptions dating back to 1995. We were also able to obtain some information about living conditions and income band to further control estimates for common confounders. In contrast to claims databases, this type of register information covers everyone in the country irrespective of insurance company, employer, age or area of residence. Because of this, information can readily be transformed into estimates of national disease burden and population attributable risk.

While the risk of fracture was strongly increased in long-term survivors of prostate cancer, the societal burden was modest with some 3% of male hip fractures being statistically attributable to prostate cancer or its treatment. But behind these numbers lie a four times increased risk of hip fracture on average, and an almost nine times increased risk in younger patients.

The two main weaknesses of the study were that the use of ADT was underestimated (the majority of ADT doses - some 85% in Denmark - are given in outpatient clinics and not through presecriptions which could be tracked to individual patients) and that patients exposed to ADT would have been those suffering from more advanced disease. In other words, while fracture risk was 70% higher in prostate cancer patients treated with ADT compared with prostate cancer patients without a register entry of such exposure, we are unable to determine whether ADT or more advanced disease itself is the main contributor to this increased risk. Our results indicate, however, that particular vigilance and fracture prevention is relevant in this subgroup of patients.

Written by Bo Abrahamsen, MD, PhD, as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract

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Dincolo de Rezumat - fracturã de risc în danezã bãrbaþi cu cancer de prostatã: Un Nationwide Registrul de studiu - Beyond The Abstract - Fracture Risk In Danish Men With Prostate Cancer: A Nationwide Register Study - articole medicale engleza - startsanatate