Risk of fracture after androgen deprivation for prostate cancer

Vahakn B. Shahinian, Yong Fang Kuo, Jean L. Freeman, James Goodwin

Research output: Contribution to journalArticle

975 Citations (Scopus)

Abstract

BACKGROUND: The use of androgen-deprivation therapy for prostate cancer has increased substantially over the past 15 years. This treatment is associated with a loss of bone-mineral density, but the risk of fracture after androgen-deprivation therapy has not been well studied. METHODS: We studied the records of 50,613 men who were listed in the linked database of the Surveillance, Epidemiology, and End Results program and Medicare as having received a diagnosis of prostate cancer in the period from 1992 through 1997. The primary outcomes were the occurrence of any fracture and the occurrence of a fracture resulting in hospitalization. Cox proportional-hazards analyses were adjusted for characteristics of the patients and the cancer, other cancer treatment received, and the occurrence of a fracture or the diagnosis of osteoporosis during the 12 months preceding the diagnosis of cancer. RESULTS: Of men surviving at least five years after diagnosis, 19.4 percent of those who received androgen-deprivation therapy had a fracture, as compared with 12.6 percent of those not receiving androgen-deprivation therapy (P<0.001). In the Cox proportional-hazards analyses, adjusted for characteristics of the patient and the tumor, there was a statistically significant relation between the number of doses of gonadotropin-releasing hormone received during the 12 months after diagnosis and the subsequent risk of fracture. CONCLUSIONS: Androgen-deprivation therapy for prostate cancer increases the risk of fracture.

Original languageEnglish (US)
Pages (from-to)154-164
Number of pages11
JournalNew England Journal of Medicine
Volume352
Issue number2
DOIs
StatePublished - Jan 13 2005

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Androgens
Prostatic Neoplasms
Therapeutics
Neoplasms
SEER Program
Medicare
Gonadotropin-Releasing Hormone
Bone Density
Osteoporosis
Hospitalization
Databases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Risk of fracture after androgen deprivation for prostate cancer. / Shahinian, Vahakn B.; Kuo, Yong Fang; Freeman, Jean L.; Goodwin, James.

In: New England Journal of Medicine, Vol. 352, No. 2, 13.01.2005, p. 154-164.

Research output: Contribution to journalArticle

Shahinian, Vahakn B. ; Kuo, Yong Fang ; Freeman, Jean L. ; Goodwin, James. / Risk of fracture after androgen deprivation for prostate cancer. In: New England Journal of Medicine. 2005 ; Vol. 352, No. 2. pp. 154-164.
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