CHARLOTTETOWN, Canada—Bone mineral density (BMD) testing and bisphosphonate use are significantly underused in men receiving androgen deprivation therapy (ADT) for prostate cancer (PCa), a new study suggests.
The study, which included 33,036 men diagnosed with prostate cancer in Ontario between 1995 and 2008, was presented at the Canadian Urological Association’s annual meeting.
Shabbir Alibhai, MD, MSc, of the University of Toronto, and six co-investigators found rates of BMD testing rose from 3% in 1995 to 22% in 2006, but the rate dropped to 20% in 2007 and 17% in 2008. In addition, the rate of BMD testing in men with prior osteoporosis rose to 41% in 2003, but fell to 35% in 2008. The researchers observed a similar pattern for BMD among men with a prior fragility fracture. Use of bisphosphonates within one year of starting ADT also rose slightly and then started to fall; the rate was 6% in 2008.
Significant predictors of BMD testing within two years of starting ADT included being younger than 85 years, living in an urban area, starting ADT after 1995, having prior osteoporosis, having a prior BMD test, having used bisphosphonates before and having a regular primary care physician. Significant predictors of bisphosphonate use included living in an urban area, starting ADT after 1995, having prior osteoporosis, having a prior fragility fracture, and having a prior BMD test.
“I was quite surprised and dismayed that there has not been greater uptake of BMD testing and bisphosphonate use, particularly the former,” Dr. Alibhai said. “I was particularly hoping we’d find greater rates of both in the years 2006 to 2008.”