Population-based retrospective cohort study of fracture risk prediction using the Fracture Risk Assessment Tool in cancer patients

The Fracture Risk Assessment Tool (FRAX) predicts 10-years probability of major osteoporotic fracture (MOF) and hip fracture in the general population. Whether FRAX is useful in individuals with cancer is uncertain. A retrospective, population-based cohort study in Manitoba, Canada, included cancer patients and individuals without a cancer diagnosis. Compared with individuals without a cancer diagnosis, those with cancer had higher rates of incident MOF (12.9 versus 14.5 per 1000 person-years; p<0.001) and hip fracture (3.5 versus 4.2 per 1000 person years; p=0.002). In the cancer cohort, FRAX with bone mineral density results were associated with incident MOF (per 1 SD increase HR 1.84; 95% CI 1.74-1.95) and hip fracture (3.61; 3.13-4.15). In the cancer cohort, calibration slopes for FRAX with bone mineral density were 1.03 for MOFs and 0.97 for hip fractures. The authors conclude that FRAX with bone mineral density can predict incident fractures in individuals with cancer.