ImportanceThe Fracture Risk Assessment Tool (FRAX) is a fracture risk prediction tool for 10-year probability of major osteoporotic fracture (MOF) and hip fracture in the general population. Whether FRAX is useful in individuals with cancer is uncertain.ObjectiveTo determine the performance of FRAX for predicting incident fractures in individuals with cancer.Design, Setting, and ParticipantsThis retrospective population-based cohort study included residents of Manitoba, Canada, with and without cancer diagnoses from 1987 to 2014. Diagnoses were identified through the Manitoba Cancer Registry. Incident fractures to March 31, 2021, were identified in population-based health care data. Data analysis occurred between January and March 2023.Main Outcomes and MeasuresFRAX scores were computed for those with bone mineral density (BMD) results that were recorded in the Manitoba BMD Registry.ResultsThis study included 9877 individuals with cancer (mean [SD] age, 67.1 [11.2] years; 8693 [88.0%] female) and 45 877 individuals in the noncancer cohort (mean [SD] age, 66.2 [10.2] years; 41 656 [90.8%] female). Compared to individuals without cancer, those with cancer had higher rates of incident MOF (14.5 vs 12.9 per 1000 person-years; P < .001) and hip fracture (4.2 vs 3.5 per 1000 person-years; P = .002). In the cancer cohort, FRAX with BMD results were associated with incident MOF (HR per SD increase, 1.84 [95% CI, 1.74-1.95]) and hip fracture (HR per SD increase, 3.61 [95% CI, 3.13-4.15]). In the cancer cohort, calibration slopes for FRAX with BMD were 1.03 for MOFs and 0.97 for hip fractures.Conclusions and RelevanceIn this retrospective cohort study, FRAX with BMD showed good stratification and calibration for predicting incident fractures in patients with cancer. These results suggest that FRAX with BMD can be a reliable tool for predicting incident fractures in individuals with cancer.

中文翻译：

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使用骨折风险评估工具预测癌症患者的骨折风险


重要性骨折风险评估工具 （FRAX） 是一种骨折风险预测工具，用于预测普通人群中严重骨质疏松性骨折 （MOF） 和髋部骨折的 10 年概率。FRAX 是否对癌症患者有用尚不确定。目的确定 FRAX 预测癌症个体新发骨折的性能。设计、设置和参与者这项基于人群的回顾性队列研究包括 1987 年至 2014 年期间被诊断为癌症和未被诊断为癌症的加拿大曼尼托巴省居民。诊断是通过曼尼托巴省癌症登记处确定的。截至 2021 年 3 月 31 日的骨折事件是在基于人群的医疗保健数据中确定的。数据分析发生在 2023 年 1 月至 3 月期间。主要结局和措施计算了那些在曼尼托巴省 BMD 登记处记录的骨密度 （BMD） 结果的人的 FRAX 评分。结果这项研究包括 9877 名癌症患者 （平均 [SD] 年龄，67.1 [11.2] 岁;8693 [88.0%] 女性） 和非癌症队列中的 45 877 名个体 （平均 [SD] 年龄， 66.2 [10.2] 岁;41 656 [90.8%] 女性）。与没有癌症的个体相比，癌症患者的 MOF 发生率更高（每 1000 人年 14.5 例对 12.9 例;P < .001） 和髋部骨折 （4.2 vs; 3.5/1000 人年;P = .002）。在癌症队列中，具有 BMD 结果的 FRAX 与事件 MOF （每 SD 增加的 HR，1.84 [95% CI，1.74-1.95]）和髋部骨折 （每SD增加的 HR，3.61 [95% CI，3.13-4.15]）相关。在癌症队列中，MOFs 和 BMD 的 FRAX 校准斜率分别为 1.03 和髋部骨折 0.97。结论和相关性在这项回顾性队列研究中，FRAX 与 BMD 在预测癌症患者新发骨折方面显示出良好的分层和校准。 这些结果表明，FRAX 与 BMD 可以成为预测癌症患者发生骨折的可靠工具。