Archives of osteoporosis · 2026
Bone mineral density testing rates and fracture risk across cancers with different mortality risks: a nationwide matched cohort study.
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Kim Seung Hoon, Choi Eunjeong, Cha Yonghan, Choi Seoyeong, Jang Suk-Yong
Аннотация
UNLABELLED: In our study, patients with cancer underwent bone mineral density testing more frequently than matched non-cancer patients. High-mortality cancers showed the highest relative rates of both BMD testing and osteoporotic fracture, whereas thyroid cancer showed comparatively low fracture risk despite higher testing rates.
BACKGROUND: We aimed to compare the rates of bone mineral density (BMD) testing and osteoporotic fractures among patients with incident cancer and matched non-cancer patients according to cancer mortality risk.
METHODS: We conducted a nationwide matched cohort study of individuals aged ≥ 50 years between 2005 and 2019. Patients with incident cancer were risk-set matched 1:2 to non-cancer patients using time-dependent propensity scores. Cancer types were categorized by mortality risk (thyroid, intermediate-, and high-mortality). Outcomes included receipt of BMD testing and incidence of osteoporotic fractures within 5 years. Cox proportional hazards models with robust variance estimators were used, with stratified analyses according to prior osteoporosis medication use.
RESULTS: The final cohort comprised 28,537 patients with cancer and 57,074 matched non-cancer patients. Overall, patients with cancer were more likely to undergo BMD testing than non-cancer patients; however, the magnitude varied by cancer mortality risk. Among patients without prior osteoporosis treatment, BMD testing was most frequent in high-mortality cancers (adjusted hazard ratio [aHR] 2.17; 95% CI 2.12-2.23), followed by thyroid (aHR 1.59; 95% CI 1.48-1.71) and intermediate-mortality cancers (aHR 1.49; 95% CI 1.45-1.54). In contrast, osteoporotic fracture risk increased stepwise with worsening cancer prognosis, with the highest risk observed in high-mortality cancers (aHR 2.80; 95% CI 2.72-2.89), while thyroid cancer was not associated with increased fracture risk.
CONCLUSIONS: Both BMD testing and fracture risk varied across cancer mortality groups, with high-mortality cancers showing the highest relative fracture risk. These findings demonstrate differing rates of BMD testing and osteoporotic fracture across cancer populations with differing prognoses.
BACKGROUND: We aimed to compare the rates of bone mineral density (BMD) testing and osteoporotic fractures among patients with incident cancer and matched non-cancer patients according to cancer mortality risk.
METHODS: We conducted a nationwide matched cohort study of individuals aged ≥ 50 years between 2005 and 2019. Patients with incident cancer were risk-set matched 1:2 to non-cancer patients using time-dependent propensity scores. Cancer types were categorized by mortality risk (thyroid, intermediate-, and high-mortality). Outcomes included receipt of BMD testing and incidence of osteoporotic fractures within 5 years. Cox proportional hazards models with robust variance estimators were used, with stratified analyses according to prior osteoporosis medication use.
RESULTS: The final cohort comprised 28,537 patients with cancer and 57,074 matched non-cancer patients. Overall, patients with cancer were more likely to undergo BMD testing than non-cancer patients; however, the magnitude varied by cancer mortality risk. Among patients without prior osteoporosis treatment, BMD testing was most frequent in high-mortality cancers (adjusted hazard ratio [aHR] 2.17; 95% CI 2.12-2.23), followed by thyroid (aHR 1.59; 95% CI 1.48-1.71) and intermediate-mortality cancers (aHR 1.49; 95% CI 1.45-1.54). In contrast, osteoporotic fracture risk increased stepwise with worsening cancer prognosis, with the highest risk observed in high-mortality cancers (aHR 2.80; 95% CI 2.72-2.89), while thyroid cancer was not associated with increased fracture risk.
CONCLUSIONS: Both BMD testing and fracture risk varied across cancer mortality groups, with high-mortality cancers showing the highest relative fracture risk. These findings demonstrate differing rates of BMD testing and osteoporotic fracture across cancer populations with differing prognoses.