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Fracture risk in patients with different types of cancer
Peter Vestergaard1, Lars Rejnmark, Leif Mosekilde
1Department of Endocrinology and Metabolism C, Aarhus Amtssygehus, Aarhus University Hospital, Aarhus, Denmark. p-vest@post4.tele.dk
Background:
Few studies on the risk of fractures in patients with cancer exist, and little is known on the mechanisms of fractures in patients with cancer. We studied the risk of fracture in patients with various types of cancer.
Subjects And Methods:
Case control study. There were 124,655 fracture cases and 373,962 age and gender matched controls.
Results:
An increased risk of fractures, primarily within the first year after diagnosis was seen in patients with primary bone cancer (OR=3.51, 95% CI: 1.54-8.01), multiple myeloma (OR=5.21, 95% CI: 2.96-9.19), metastases to the bone (OR=5.28, 95% CI: 3.58-7.79), metastases to other organs than bone (OR=1.85, 95% CI: 1.50-2.29), lung cancer (OR=1.90, 95% CI: 1.51-2.38), and cancer of the liver, gall bladder and pancreas (2.14, 95% CI: 1.39-3.31). For patients with prostate cancer an increase in the risk of fractures was seen with time. Other cancer types were not associated with an increased risk of fractures.
Conclusions:
A high risk group regarding fractures includes cancers primarily affecting the bone (primary bone cancer, multiple myeloma, metastases to the bone, metastases to other organs than bone, lung cancer, and cancer of the liver, gall bladder and pancreas, and prostate cancer). The main increase in risk of fractures in this group was seen within the first year following diagnosis. A low risk group for fractures included all other cancer types (e.g. cancer of the breast, colon, skin etc). This may have implication for which patients should be selected for prevention against fractures.
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