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Risk of Pelvic Insufficiency Fractures in Cervical Cancer Survivors: Using the National Claim Database
Ki-Tae Park1, Jung-Wee Park1,2, Ye Jin Jeon3
1Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Journal of Korean Medical Science
|November 25, 2025
Summary
Pelvic insufficiency fractures (PIF) affect 1.0% of cervical cancer patients. Older age and pelvic radiation therapy (RT) significantly increase the risk of developing PIF in these survivors.
Area of Science:
- Oncology
- Radiotherapy
- Epidemiology
Background:
- Cervical cancer survival is improving due to advancements in pelvic radiation therapy (RT).
- Pelvic insufficiency fractures (PIF) are a known complication in cervical cancer patients.
- Identifying risk factors for PIF is crucial for patient management.
Purpose of the Study:
- To estimate the incidence of PIF in cervical cancer patients.
- To identify risk factors associated with PIF development in this population.
Main Methods:
- Utilized a national claim database linking Korean National Health Insurance Service and Korea Central Cancer Registry data (2007-2016).
- Included 13,480 cervical cancer patients, categorized into PIF and non-PIF groups.
- Employed multivariate Cox proportional hazards regression to assess risk factors like age, RT, and comorbidities.
Main Results:
- The overall incidence of PIF was 1.0% (134 out of 13,480 patients).
- Older age (aHR, 1.063) and pelvic radiation therapy (aHR, 1.829) were significantly associated with increased PIF risk.
- Statistical significance was observed for both factors (P < 0.001 for age, P = 0.003 for RT).
Conclusions:
- The incidence of PIF in cervical cancer survivors is 1.0%.
- Older age and pelvic RT are significant risk factors for PIF.
- Clinicians should monitor older patients undergoing RT for potential PIF development.
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