Table 4.
Predictorsa of Fracture (Fx) Risk Among 742 Olmsted County, MN Men With Prostate Cancer First Diagnosed in 1990–99, After Adjustment for age at Diagnosis, by Treatment Group and Fracture Type
| Entire cohort | ADTb | No ADTc | |||
|---|---|---|---|---|---|
| Risk factor | Any Fx N = 482 | Any Fx (N=201) | Pathologic Fx (N=53) | Any Fx (N=281) | Osteoporotic Fxd(N=73) |
| HR (95% CI)e | HR (95% CI)e | HR (95% CI)e | HR (95% CI)e | HR (95% CI)e | |
| Advanced stage | 2.1 (1.4–3.1) | 1.7 (1.1–2.6) | 3.7 (1.4–10) | 1.5 (0.6–4.0) | 0.9 (0.3–2.7) |
| Poorly differentiated grade | 1.6 (0.96–2.7) | 1.3 (0.8–2.3) | 1.6 (0.5–5.4) | 0.6 (0.2–1.7) | 0.4 (0.0–6.0) |
| PSA at baseline (per 500 units) | 1.3 (1.1–1.6) | 1.3 (1.04–1.6) | 1.5 (1.1–1.9) | 0.0 (0.0–10) | 0.7 (0.02–36) |
| Bilateral orchiectomy | 1.8 (1.2–2.6) | 1.3 (0.9–2.1) | 2.3 (0.9–5.8) | - | - |
| Use of GnRH | 1.4 (0.98–2.0) | 0.9 (0.6–1.3) | 0.5 (0.2–1.2) | - | - |
| Primary androgen blockade | 1.7 (1.3–2.3) | 1.3 (0.6–2.7) | 1.4 (0.2–11) | - | - |
| Use of nonsteroidal anti-androgens | 1.9 (1.3–2.7) | 1.4 (0.9–2.1) | 4.7 (1.8–12) | - | - |
| Use of steroidal anti-androgens | 2.1 (1.2–3.7) | 1.5 (0.9–2.7) | 1.4 (0.5–4.4) | - | - |
| Any combined androgen blockade | 2.0 (1.3–2.8) | 1.5 (0.99–2.2) | 3.2 (1.2–8.1) | - | - |
| Any pelvic radiation therapy | 1.4 (1.1–1.9) | 1.5 (0.99–2.2) | 6.0 (1.4–26) | 1.3 (0.8–2.0) | 1.5 (0.8–2.8) |
| Any chemotherapy | 2.0 (1.3–3.1) | 2.0 (1.2–3.3) | 6.0 (2.4–15) | 1.8 (0.9–3.7) | 1.0 (0.2–3.6) |
| Use of glucocorticoids | 2.0 (1.4–2.7) | 2.4 (1.5–3.7) | 5.8 (2.7–12) | 1.6 (1.04–2.5) | 1.5 (0.8–2.8) |
| Prior osteoporotic fracture | 1.7 (1.1–2.7) | 1.5 (0.9–2.5) | 0.2 (0.02–1.2) | 1.8 (0.9–3.5) | 1.4 (0.5–4.0) |
| Use of osteoporosis drugs | 3.5 (2.3–5.5) | 2.5 (1.3–4.8) | 3.8 (1.2–12) | 4.6 (2.7–7.8) | 9.7 (5.0–19) |
| Risk factors for 2° osteoporosis | 1.3 (0.95–1.8) | 1.0 (0.7–1.6) | 0.8 (0.3–2.2) | 1.6 (1.02–2.4) | 2.0 (1.1–3.8) |
| Risk factors for falling | 1.4 (1.04–1.8) | 1.2 (0.8–1.8) | 0.7 (0.2–2.4) | 1.6 (1.1–2.4) | 2.3 (1.2–4.3) |
| Use of anticoagulants | 1.7 (1.3–2.3) | 1.7 (1.1–2.5) | 1.8 (0.7–4.7) | 1.8 (1.2–2.8) | 2.1 (1.2–3.7) |
| Obesity | 1.1 (0.8–1.5) | 0.7 (0.4–1.1) | 0.4 (0.1–1.2) | 1.4 (0.9–2.1) | 0.9 (0.4–1.9) |
| Inactivity | 1.1 (0.5–2.3) | 0.8 (0.4–2.0) | 0.2 (0–3.5) | 1.1 (0.3–3.7) | 0.2 (0–3.9) |
Age-adjusted univariable analyses; statistically significant (P < 0.05) associations are bolded. The numbers of affected men in each instance are shown in Table 1.
Ever had any androgen deprivation therapy (ADT); time in model begins at first ADT (N = 279).
Never had ADT (N=463) or time in model prior to ADT in those who had it (N=247).
Fractures of the proximal femur, distal radius or thoracic/lumbar vertebrae due to minimal or moderate trauma, excluding pathologic fractures and those diagnosed incidentally on follow-up x-rays.
Hazard ratio (HR) and 95% confidence interval (CI).