Document Detail


Fracture risk increases after diagnosis of breast or other cancers in postmenopausal women: results from the Women's Health Initiative.
MedLine Citation:
PMID:  18766294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
SUMMARY: Risk for falls and fractures increases after breast cancer or other cancer diagnosis in postmenopausal women. Factors other than falls may be the major causes for the increased fracture risk. INTRODUCTION: Cancer treatment and prognosis may have detrimental effects on bone health. However, there is a lack of prospective investigations on fracture risk among incident cancer cases. METHODS: In this study, postmenopausal women (N = 146,959) from the Women's Health Initiative prospective cohort, who had no cancer history at baseline, were followed for up to 9 years and classified into no cancer, incident breast cancer (BC) and incident other cancer (OC) groups. The main outcomes measured were incident fractures and falls before and after cancer diagnosis. Hazards ratios (HR) and 95% confidence intervals (CI) were computed from Cox proportional hazards model. RESULTS: While hip fracture risk before a cancer diagnosis was similar between the no cancer and cancer groups, hip fracture risk was significantly higher after BC diagnosis (HR = 1.55, CI = 1.13-2.11) and the elevated risk was even more notable after OC diagnosis (HR = 2.09, CI = 1.65-2.65). Risk of falls also increased after BC (HR = 1.15, CI = 1.06-1.25) or OC diagnosis (HR = 1.27, CI = 1.18-1.36), but could not fully explain the elevated hip fracture risk. Incident clinical vertebral and total fractures were also significantly increased after OC diagnosis (p < 0.05). CONCLUSIONS: Postmenopausal women have significantly elevated risks for falls and fractures after a cancer diagnosis. The causes for this increased risk remained to be investigated.
Authors:
Z Chen; M Maricic; A K Aragaki; C Mouton; L Arendell; A M Lopez; T Bassford; R T Chlebowski
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2008-09-03
Journal Detail:
Title:  Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA     Volume:  20     ISSN:  1433-2965     ISO Abbreviation:  Osteoporos Int     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-05     Completed Date:  2010-01-14     Revised Date:  2010-09-21    
Medline Journal Info:
Nlm Unique ID:  9100105     Medline TA:  Osteoporos Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  527-36     Citation Subset:  IM    
Affiliation:
Division of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ 85724-5211, USA. zchen@u.arizona.edu
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MeSH Terms
Descriptor/Qualifier:
Accidental Falls / statistics & numerical data
Aged
Breast Neoplasms / complications,  drug therapy,  epidemiology
Epidemiologic Methods
Female
Fractures, Bone / epidemiology,  etiology*
Hip Fractures / epidemiology,  etiology
Humans
Middle Aged
Neoplasms / complications*,  drug therapy,  epidemiology
Postmenopause
Spinal Fractures / epidemiology,  etiology
United States / epidemiology
Grant Support
ID/Acronym/Agency:
N01 WH32115/WH/WHI NIH HHS
Comments/Corrections

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