Performance of FRAX in men with prostate cancer: A registry-based cohort study
Performance of FRAX in men with prostate cancer: A registry-based cohort study
The Fracture Risk Assessment Tool (FRAX®) was created to predict major osteoporotic fractures (MOF) and hip fractures in the general population. Whether FRAX accurately predicts fractures in men with prostate cancer is unknown. Our objective was to assess the performance of FRAX for predicting incident fractures in men with prostate cancer. Men from the Manitoba Bone Mineral Density (BMD) Registry (1996-2018) with prostate cancer diagnoses in the 3 years prior to dual-energy X-ray absorptiometry (DXA) were identified. FRAX scores with and without BMD were calculated. From population-based healthcare data we identified incident MOF, hip fracture, any osteoporotic fracture and death from the date of BMD testing to March 31, 2018. Cox regression was performed to estimate hazard ratios (HRs) with 95% confidence intervals (95% CIs) per standard deviation increase in FRAX score. Observed 10-year probability (estimated with competing risk of mortality) was compared with 10-year FRAX-predicted fracture probability to assess calibration. The study population included 684 men with prostate cancer (mean age 74.6 years) and 8608 men without prostate cancer (mean age 65.5 years). FRAX stratified risk for MOF (HR 1.91, 95% CI 1.48-2.45 with BMD; HR 1.96, 95% CI 1.43-2.69 without BMD) and hip fracture (HR 3.37, 95% CI 1.90-6.01 with BMD; HR 4.58, 95% CI 2.17-9.67 without BMD) in men with prostate cancer. There was no effect modification observed with prostate cancer status or current androgen deprivation therapy. Observed 10-year fracture probability in men with prostate cancer showed good agreement with FRAX with and without BMD included in the calculation (observed/predicted calibration ratios MOF 0.97, hip 1.00 with BMD; MOF 0.92, hip 0.93 with BMD). In conclusion, FRAX reliably predicts incident fractures in men with prostate cancer. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
659-664
Ye, Carrie
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Morin, Suzanne N.
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Lix, Lisa M.
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McCloskey, Eugene V.
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Johansson, Helena
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Harvey, Nicholas C.
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Kanis, John A.
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Leslie, William D.
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May 2023
Ye, Carrie
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Morin, Suzanne N.
68489af8-f604-4f28-88e0-60add9fde4ae
Lix, Lisa M.
2fb61783-047d-4a4b-a45d-e09ac0763a7b
McCloskey, Eugene V.
2f057a16-3d4e-4597-80c7-6ce47f969c78
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Harvey, Nicholas C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Kanis, John A.
f1621d8d-8afb-4d97-9679-2165d88a344d
Leslie, William D.
5b2dd5d6-4569-40a3-a9b1-95152d11e4f1
Ye, Carrie, Morin, Suzanne N., Lix, Lisa M., McCloskey, Eugene V., Johansson, Helena, Harvey, Nicholas C., Kanis, John A. and Leslie, William D.
(2023)
Performance of FRAX in men with prostate cancer: A registry-based cohort study.
Journal of Bone and Mineral Research, 38 (5), .
(doi:10.1002/jbmr.4793).
Abstract
The Fracture Risk Assessment Tool (FRAX®) was created to predict major osteoporotic fractures (MOF) and hip fractures in the general population. Whether FRAX accurately predicts fractures in men with prostate cancer is unknown. Our objective was to assess the performance of FRAX for predicting incident fractures in men with prostate cancer. Men from the Manitoba Bone Mineral Density (BMD) Registry (1996-2018) with prostate cancer diagnoses in the 3 years prior to dual-energy X-ray absorptiometry (DXA) were identified. FRAX scores with and without BMD were calculated. From population-based healthcare data we identified incident MOF, hip fracture, any osteoporotic fracture and death from the date of BMD testing to March 31, 2018. Cox regression was performed to estimate hazard ratios (HRs) with 95% confidence intervals (95% CIs) per standard deviation increase in FRAX score. Observed 10-year probability (estimated with competing risk of mortality) was compared with 10-year FRAX-predicted fracture probability to assess calibration. The study population included 684 men with prostate cancer (mean age 74.6 years) and 8608 men without prostate cancer (mean age 65.5 years). FRAX stratified risk for MOF (HR 1.91, 95% CI 1.48-2.45 with BMD; HR 1.96, 95% CI 1.43-2.69 without BMD) and hip fracture (HR 3.37, 95% CI 1.90-6.01 with BMD; HR 4.58, 95% CI 2.17-9.67 without BMD) in men with prostate cancer. There was no effect modification observed with prostate cancer status or current androgen deprivation therapy. Observed 10-year fracture probability in men with prostate cancer showed good agreement with FRAX with and without BMD included in the calculation (observed/predicted calibration ratios MOF 0.97, hip 1.00 with BMD; MOF 0.92, hip 0.93 with BMD). In conclusion, FRAX reliably predicts incident fractures in men with prostate cancer. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Text
JBMR REVISION Manuscript Performance of FRAX in Men with Prostate Cancer_ A Registry-Based Cohort Study-clean version (1)
- Accepted Manuscript
Text
J of Bone Mineral Res - 2023 - Ye - Performance of FRAX in Men With Prostate Cancer A Registry‐Based Cohort Study (1)
- Version of Record
More information
Accepted/In Press date: 17 February 2023
e-pub ahead of print date: 20 February 2023
Published date: May 2023
Additional Information:
Funding Information:
SNM is a researcher des Fonds de Recherche du Québec en Santé. LML is supported by a Tier I Canada Research Chair.
Funding Information:
The authors acknowledge the Manitoba Centre for Health Policy for use of data contained in the Population Health Research Data Repository (HIPC 2016/2017-29). The results and conclusions are those of the authors and no official endorsement by the Manitoba Centre for Health Policy, Manitoba Health, Seniors and Active Living, or other data providers is intended or should be inferred. This article has been reviewed and approved by the members of the Manitoba Bone Density Program Committee. SNM is a researcher des Fonds de Recherche du Québec en Santé. LML is supported by a Tier I Canada Research Chair.
Publisher Copyright:
© 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Identifiers
Local EPrints ID: 475748
URI: http://eprints.soton.ac.uk/id/eprint/475748
ISSN: 0884-0431
PURE UUID: 99a860be-d32a-41c6-ab8e-8878dffa73a2
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Date deposited: 27 Mar 2023 16:46
Last modified: 17 Mar 2024 02:59
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Contributors
Author:
Carrie Ye
Author:
Suzanne N. Morin
Author:
Lisa M. Lix
Author:
Eugene V. McCloskey
Author:
Helena Johansson
Author:
John A. Kanis
Author:
William D. Leslie
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