Osteoporosis Amongst Testicular Cancer Survivors: Long Term Follow-Up of the Veterans Affairs Health System

Testicular cancer (TC) is the most common malignancy among young males and is associated with cure rates over 95%. However, the long-term health implications of treatments, such as the risk of osteoporosis, remain inadequately understood. This study aims to explore the incidence of osteoporosis in TC survivors and associated risk factors.

This retrospective study utilized data from the Veterans Affairs (VA) national electronic health record system, identifying 1686 TC patients and 7412 matched noncancer controls. The incidence of osteoporosis was determined through diagnosis codes and osteoporosis medication prescriptions. Statistical analyses, including chi-squared tests, t-tests, and Cox proportional hazards models, were employed to evaluate risk factors.

TC survivors exhibited a significantly elevated hazard of developing osteoporosis (HR =2.18; 95% CI, 1.52-3.14; P < .001), which persisted after adjusting for covariates (HR = 1.58; 95% CI, 0.99-2.51; P = .013). There was no significant TC treatment-specific effect: neither radiation nor chemotherapy were associated with an increased hazard of osteoporosis in multivariable analysis.

TC survivors face a higher hazard of osteoporosis, with age at diagnosis being a significant factor. These findings highlight the need for regular bone health monitoring in TC survivors. Future prospective studies are necessary to validate these results and better understand the mechanisms linking TC, hypogonadism, and osteoporosis risk.