Physician practices of bone density testing and drug prescribing to prevent or treat osteoporosis during androgen deprivation therapy [An erratum to this Article has been published in Cancer 2006;106(11):2530]

Authors

  • Tawee Tanvetyanon M.D.

    Corresponding author
    1. Division of Hematology and Oncology, Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois
    2. Medical Service, Edward Hines Jr. Veterans Administration Hospital, Hines, Illinois
    • Division of Hematology/Oncology, Cardinal Bernardin Cancer Center, Loyola University Chicago Medical Center, 2160 South First Avenue, Maywood, IL 60153
    Search for more papers by this author
    • Fax: (708) 327-3326


  • The opinions expressed herein do not necessarily reflect the views of the U.S. Department of Veterans Affairs.

Abstract

BACKGROUND

Androgen deprivation therapy (ADT) is a strong risk factor for osteoporosis. The current study identified physician practices in preventing or treating osteoporosis during ADT. The practices of interest are the uses of dual-energy X-ray absorptiometry (DXA) scans, bisphosphonates, calcium or vitamin D supplement, calcitonin, or estrogen.

METHODS

A retrospective medical record review was conducted. Patients were included if they had received ADT with goserelin injection for ≥ 1 year. Multivariable logistic regression analysis was performed to identify independent predictors of receiving at least one intervention.

RESULTS

Analyses included 184 patients. Most were the elderly with multiple risk factors for osteoporosis. Only 8.7% (95% confidence interval [CI], 4.6–13.0%) of patients received a DXA scan at least once during the past 3 years. Oral and intravenous bisphosphonates were prescribed in 4.9% (95%CI, 1.8–8.0%) and 0.5% (95%CI, 0–2.0%) of patients, respectively, during the past year. Overall, 14.7% of patients (95%CI, 9.5–20.0%) received at least one intervention. Concurrent risk factors for osteoporosis, including smoking, alcoholism, advanced age, low body mass index, long duration of ADT, multiple comorbidities, history of fractures, and steroid use, were not independent predictors of having received interventions. However, bone metastasis was, with a hazard ratio of 5.6 (95%CI, 1.99–15.6%). Primary care physicians provided the greatest number of interventions and cancer-related specialists provided the fewest.

CONCLUSIONS

The majority of patients with prostate carcinoma undergoing ADT did not receive interventions to prevent or treat osteoporosis. Having other concurrent risk factors for osteoporosis was not predictive of receiving these few interventions. [An erratum to this Article has been published in Cancer 2006;106(11):2530] Cancer 2005. © 2004 American Cancer Society.

Ancillary