Journal Article

Fracture risk among patients with cancer compared to individuals without cancer: a population-based study

Cheung, Matthew C, Gong, Inna Y, Chan, Kelvin K. W, Lipscombe, Lorraine L, Mozessohn, Lee

2023

Overview

BackgroundPatients with cancer may be at increased risk of osteoporosis and fracture; however, gaps exist in the existing literature and the association between cancer and fracture requires further examination.MethodsWe conducted a population-based cohort study of Ontario patients with cancer (breast, prostate, lung, gastrointestinal, haematologic) diagnosed between January 2007 to December 2018 and 1:1 matched non-cancer controls. The primary outcome was incident fracture (end of follow-up December 2019). Multivariable Cox regression analysis was used to estimate the relative fracture risk with sensitivity analysis accounting for competing risk of death.ResultsAmong 172,963 cancer patients with non-cancer controls, 70.6% of patients with cancer were <65 years old, 58% were female, and 9375 and 8141 fracture events were observed in the cancer and non-cancer group, respectively (median follow-up 6.5 years). Compared to non-cancer controls, patients with cancer had higher risk of fracture (adjusted HR [aHR] 1.10, 95% CI 1.07–1.14, p < 0.0001), which was also observed for both solid (aHR 1.09, 95% CI 1.05–1.13, p < 0.0001) and haematologic cancers (aHR 1.20, 95% CI 1.10–1.31, p < 0.0001). Sensitivity analysis accounting for competing risk of death did not change these findings.ConclusionsOur study indicates that patients with cancer are at modest risk of fractures compared to non-cancer controls.

• Publisher: Nature Publishing Group
• Subject: Blood cancer / Breast cancer / Cancer / Fractures / Gastric cancer / Health risks / Lung cancer / Osteoporosis / Population studies / Population-based studies / Prostate cancer / Sensitivity analysis