Vertebral fractures among breast cancer survivors in China: a cross-sectional study of prevalence and health services gaps
Abstract Background Breast cancer survivors are at high risk for fracture due to cancer treatment-induced bone loss, however, data is scarce regarding the scope of this problem from an epidemiologic and health services perspective among Chinese women with breast cancer. Methods We designed a cross-s...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-018-4014-5 |
| _version_ | 1811317831013236736 |
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| author | Evelyn Hsieh Qin Wang Renzhi Zhang Xin Niu Weibo Xia Liana Fraenkel Karl L. Insogna Jing Li Jennifer S. Smith Chunwu Zhou You-lin Qiao Pin Zhang |
| author_facet | Evelyn Hsieh Qin Wang Renzhi Zhang Xin Niu Weibo Xia Liana Fraenkel Karl L. Insogna Jing Li Jennifer S. Smith Chunwu Zhou You-lin Qiao Pin Zhang |
| author_sort | Evelyn Hsieh |
| collection | DOAJ |
| description | Abstract Background Breast cancer survivors are at high risk for fracture due to cancer treatment-induced bone loss, however, data is scarce regarding the scope of this problem from an epidemiologic and health services perspective among Chinese women with breast cancer. Methods We designed a cross-sectional study comparing prevalence of vertebral fractures among age- and BMI-matched women from two cohorts. Women in the Breast Cancer Survivors cohort were enrolled from a large cancer hospital in Beijing. Eligibility criteria included age 50–70 years, initiation of treatment for breast cancer at least 5 years prior to enrollment, and no history of metabolic bone disease or bone metastases. Data collected included sociodemographic characteristics; fracture-related risk factors, screening and preventive measures; breast cancer history; and thoracolumbar x-ray. The matched comparator group was selected from participants enrolled in the Peking Vertebral Fracture Study, an independent cohort of healthy community-dwelling postmenopausal women from Beijing. Results Two hundred breast cancer survivors were enrolled (mean age 57.5 ± 4.9 years), and compared with 200 matched healthy women. Twenty-two (11%) vertebral fractures were identified among breast cancer survivors compared with 7 (3.5%) vertebral fractures in the comparison group, yielding an adjusted odds ratio for vertebral fracture of 4.16 (95%CI 1.69–10.21, p < 0.01). The majority had early stage (85.3%) and estrogen and/or progesterone receptor positive (84.6%) breast cancer. Approximately half of breast cancer survivors reported taking calcium supplements, 6.1% reported taking vitamin D supplements, and only 27% reported having a bone density scan since being diagnosed with breast cancer. Conclusions Despite a four-fold increased odds of prevalent vertebral fracture among Chinese breast cancer survivors in our study, rates of screening for osteoporosis and fracture risk were low reflecting a lack of standardization of care regarding cancer-treatment induced bone loss. |
| first_indexed | 2024-04-13T12:16:29Z |
| format | Article |
| id | doaj.art-a85f813611fa4486a05b10394e8932c6 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-13T12:16:29Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-a85f813611fa4486a05b10394e8932c62022-12-22T02:47:22ZengBMCBMC Cancer1471-24072018-01-011811910.1186/s12885-018-4014-5Vertebral fractures among breast cancer survivors in China: a cross-sectional study of prevalence and health services gapsEvelyn Hsieh0Qin Wang1Renzhi Zhang2Xin Niu3Weibo Xia4Liana Fraenkel5Karl L. Insogna6Jing Li7Jennifer S. Smith8Chunwu Zhou9You-lin Qiao10Pin Zhang11Section of Rheumatology, Yale School of MedicineDepartment of Ultrasound, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Endocrinology, Key Laboratory of Endocrinology, Peking Union Medical College HospitalSection of Rheumatology, Yale School of MedicineSection of Endocrinology, Yale School of MedicineDepartment of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Epidemiology, UNC Gillings School of Global Public HealthDepartment of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Cancer Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeAbstract Background Breast cancer survivors are at high risk for fracture due to cancer treatment-induced bone loss, however, data is scarce regarding the scope of this problem from an epidemiologic and health services perspective among Chinese women with breast cancer. Methods We designed a cross-sectional study comparing prevalence of vertebral fractures among age- and BMI-matched women from two cohorts. Women in the Breast Cancer Survivors cohort were enrolled from a large cancer hospital in Beijing. Eligibility criteria included age 50–70 years, initiation of treatment for breast cancer at least 5 years prior to enrollment, and no history of metabolic bone disease or bone metastases. Data collected included sociodemographic characteristics; fracture-related risk factors, screening and preventive measures; breast cancer history; and thoracolumbar x-ray. The matched comparator group was selected from participants enrolled in the Peking Vertebral Fracture Study, an independent cohort of healthy community-dwelling postmenopausal women from Beijing. Results Two hundred breast cancer survivors were enrolled (mean age 57.5 ± 4.9 years), and compared with 200 matched healthy women. Twenty-two (11%) vertebral fractures were identified among breast cancer survivors compared with 7 (3.5%) vertebral fractures in the comparison group, yielding an adjusted odds ratio for vertebral fracture of 4.16 (95%CI 1.69–10.21, p < 0.01). The majority had early stage (85.3%) and estrogen and/or progesterone receptor positive (84.6%) breast cancer. Approximately half of breast cancer survivors reported taking calcium supplements, 6.1% reported taking vitamin D supplements, and only 27% reported having a bone density scan since being diagnosed with breast cancer. Conclusions Despite a four-fold increased odds of prevalent vertebral fracture among Chinese breast cancer survivors in our study, rates of screening for osteoporosis and fracture risk were low reflecting a lack of standardization of care regarding cancer-treatment induced bone loss.http://link.springer.com/article/10.1186/s12885-018-4014-5Breast cancerCancer treatment-induced bone lossVertebral fractureChina |
| spellingShingle | Evelyn Hsieh Qin Wang Renzhi Zhang Xin Niu Weibo Xia Liana Fraenkel Karl L. Insogna Jing Li Jennifer S. Smith Chunwu Zhou You-lin Qiao Pin Zhang Vertebral fractures among breast cancer survivors in China: a cross-sectional study of prevalence and health services gaps BMC Cancer Breast cancer Cancer treatment-induced bone loss Vertebral fracture China |
| title | Vertebral fractures among breast cancer survivors in China: a cross-sectional study of prevalence and health services gaps |
| title_full | Vertebral fractures among breast cancer survivors in China: a cross-sectional study of prevalence and health services gaps |
| title_fullStr | Vertebral fractures among breast cancer survivors in China: a cross-sectional study of prevalence and health services gaps |
| title_full_unstemmed | Vertebral fractures among breast cancer survivors in China: a cross-sectional study of prevalence and health services gaps |
| title_short | Vertebral fractures among breast cancer survivors in China: a cross-sectional study of prevalence and health services gaps |
| title_sort | vertebral fractures among breast cancer survivors in china a cross sectional study of prevalence and health services gaps |
| topic | Breast cancer Cancer treatment-induced bone loss Vertebral fracture China |
| url | http://link.springer.com/article/10.1186/s12885-018-4014-5 |
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