Adult cancer survivors at higher risk of bone fractures, say researchers

According to a recent large study by researchers at the American Cancer Society, adult cancer survivors, particularly those diagnosed within five years and/or have a history of chemotherapy, have an increased risk for bone fractures, specifically pelvic and vertebral fractures, compared to older adults without cancer (ACS).

Additionally, survivors who were physically active had a lower probability of breaking a bone, while survivors who smoked had a higher risk. The results were released today in JAMA Oncology, the journal of the American Medical Association.

"These findings are important as the number of cancer survivors living in the United States is projected to rise to 26.1 million by 2040. Research like this seeks ways for cancer survivors to have a better quality of life after their diagnosis," said Dr Erika Rees-Punia, senior principal scientist, of behavioural and epidemiology research at the American Cancer Society and lead author of the study. "Fractures of the pelvis and vertebrae are more than just broken bones - they are serious and costly."

Researchers looked examined information from the 1997-2017 Medicare claims-linked Cancer Prevention Study-II Nutrition Cohort participants. In comparison to persons without a history of cancer, they looked into the relationships between cancer diagnoses, including the length of time since and stage at diagnosis, and the risk of pelvic, radial, and vertebral fractures (both independently and jointly). In addition, they looked at variations in fracture risk according to treatment, cancer type, and modifiable behaviour.

The findings showed that 12,943 of the 92,431 study participants had bone fractures attributable to their fragility. Cancer survivors who had their most recent cancer diagnosis during the previous five years with an advanced stage had the highest risk of fracture compared to participants without a history of the disease.

The vertebral and pelvic fracture sites were mostly responsible for the greater fracture risk in cancer survivors. Chemotherapy recipients had a higher risk of fracture compared to cancer survivors who did not get chemotherapy; this link was more pronounced within five years of diagnosis but remained suggestive five years later.

The study also demonstrated that among cancer survivors 5 or more years after diagnosis, physical exercise may be related to a lower risk of fracture and that continued smoking was associated with a greater risk.

"We hope our findings will inform clinical guidance on fracture prevention, which could incorporate physical activity with exercise cancer professionals and smoking cessation programs, to improve quality of life after a cancer diagnosis," added Rees-Punia.