Cohort study of adherence to guidelines recommending testing for treatment-related toxicities of ADT for prostate cancer in Ontario

Androgen-deprivation therapy (ADT) is a cornerstone of treatment for advanced prostate cancer. ADT is associated with several adverse effects, including osteoporosis, metabolic syndrome, and cardiovascular events. Guidelines recommend routine testing to monitor for these toxicities. A retrospective cohort study in Ontario, Canada, investigated adherence to these guidelines. Among 29.097 patients (aged 65 years or older) receiving ADT for prostate cancer from 2008 to 2021, only 21.3% received a bone density scan, 41.2% underwent bone health serum tests, 51.3% completed a lipid profile, and 65.9% underwent dysglycemia testing within 1 year of diagnosis. Only 11.9% of patients received all of the recommended investigations. Adherence to testing did not improve over time (2008-2021). The authors conclude that most patients receiving ADT for prostate cancer do not receive recommended testing to monitor for treatment-related toxicity.