Summary

Epidemiological studies show an inconsistent association between cancer and osteoporosis. In this nationally representative population-based study, we found that a prior cancer diagnosis was not associated with osteoporosis. This finding may primarily apply to cancer survivors seen many years after their cancer diagnosis.

Background

Epidemiological studies show an inconsistent association between cancer and osteoporosis. We examined the association between a prior cancer diagnosis and osteoporosis in population-based data.

Methods

We performed an age- and sex-matched case–control study (1:2 matching ratio) using the National Health and Nutrition Examination Survey, 2011–2018. Cases were determined by self-reported prior diagnosis of cancer; all controls were free of cancer at the time of bone density measurement with dual-energy x-ray absorptiometry. We defined osteoporosis as a T-score ≤ − 2.5 at femoral neck, total hip, or lumbar spine. Unconditional multivariable logistic regression was used to test the association between a prior cancer diagnosis and osteoporosis.

Results

We identified 246 prior cancer cases and 492 controls (mean age: 65.8 years) in females, and 243 prior cancer cases and 486 controls (mean age: 68.0 years) in males. The most common types of cancer in females and males were breast cancer and prostate cancer, respectively. Osteoporosis prevalences were comparable between cases and controls among females (19.1% in cases vs. 18.7% in controls; P = 0.894) and males (5.8% in cases vs. 6.8% in controls; P = 0.594). After adjusting for covariates, a prior cancer diagnosis was not associated with osteoporosis in females (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.54–1.29) or males (OR: 1.09; 95% CI: 0.51–2.30). Results were unaffected by cancer severity, cancer type, or time since cancer diagnosis.

Conclusions

A prior cancer diagnosis was not associated with osteoporosis in this nationally representative population.

中文翻译：

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既往癌症诊断与骨质疏松症之间的关联：匹配病例对照研究

概括

流行病学研究表明癌症与骨质疏松症之间的关联不一致。在这项具有全国代表性的基于人群的研究中，我们发现先前的癌症诊断与骨质疏松症无关。这一发现可能主要适用于癌症诊断多年后的癌症幸存者。

背景

流行病学研究表明癌症与骨质疏松症之间的关联不一致。我们在基于人群的数据中检查了既往癌症诊断与骨质疏松症之间的关联。

方法

我们使用 2011-2018 年全国健康和营养检查调查进行了一项年龄和性别匹配的病例对照研究（匹配比为 1:2）。病例根据自我报告的既往癌症诊断确定；在使用双能 X 射线骨密度测定法测量骨密度时，所有对照均未患癌症。我们将骨质疏松症定义为股骨颈、全髋或腰椎的 T 值≤-2.5。使用无条件多变量逻辑回归来测试先前的癌症诊断与骨质疏松症之间的关联。

结果

我们在女性中确定了 246 例既往癌症病例和 492 例对照（平均年龄：65.8 岁），在男性中确定了 243 例既往癌症病例和 486 例对照（平均年龄：68.0 岁）。女性和男性最常见的癌症类型分别是乳腺癌和前列腺癌。在女性（病例 19.1% 对对照组 18.7%；P  = 0.894）和男性（病例 5.8% 对对照组 6.8%；P = 0.594  ）中，骨质疏松症患病率在病例和对照组之间具有可比性。调整协变量后，先前的癌症诊断与女性骨质疏松症无关（比值比 [OR]：0.83；95% 置信区间 [CI]：0.54–1.29）或男性（OR：1.09；95% CI：0.51– 2.30). 结果不受癌症严重程度、癌症类型或癌症诊断后时间的影响。

结论

在这个具有全国代表性的人群中，先前的癌症诊断与骨质疏松症无关。