Prostate Cancer Coverage from Every Angle

Is BMD Testing After Treatment for Prostate Cancer Meeting Guideline Recommendations?

By: Hillary Ojeda
Posted: Monday, November 9, 2020

Bone mineral density (BMD) testing rates were low in patients with prostate cancer who were starting androgen-deprivation therapy (ADT), according to a study by Alice Dragomir, MSc, PhD, of McGill University, Montreal, and colleagues. In the study, published in the JNCCN–Journal of the National Comprehensive Cancer Network, the authors suggested treatment guidelines for advanced prostate cancer should encourage testing.

"Although we expected BMD testing rates to be fairly low given the prior literature, we were somewhat surprised that they didn’t go up more in recent years," said Dr. Dragomir in an NCCN press release.

For this study, the authors reviewed data for 22,033 patients with prostate cancer from the Canadian database, the Régie de l’assurance maladie du Québec (RAMQ). The patients began receiving ADT between January 2000 and December 2015. The primary study outcome was having BMD testing done in the time period starting at 6 months before and through 12 months after the start of ADT.

Of the 22,033 patients, a total of 3,910 (17.8%) were tested for BMD. From 2000 to 2015, the percentage of patients who underwent testing increased from 4.1% to 23.4%. Several factors associated with a higher likelihood of testing included a history of osteoporosis, rheumatoid arthritis, use of bisphosphonates, and long-term corticosteroid use. However, factors associated with a lower likelihood of testing included age of 80 or older, metastases, higher Charlson comorbidity score, and rural residence.

The number of patients who underwent BMD testing between 6 months before and up to 12 after starting ADT throughout the study period was low at 17.8%, the authors reported. However, they added that this number increased during the study period, reaching almost 25% of patients in the last year of the study.

Disclosure: The study authors reported no conflicts of interest.

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