title: Estimation of the lifetime risk of hip fracture for women and men in Canada.
abstract: In Canada in 2008, based on current rates of fracture and mortality, a woman or man at age 50 years will have a projected lifetime risk of fracture of 12.1% and 4.6%, respectively, and 8.9% and 6.7% after incorporating declining rates of hip fracture and increases in longevity.
  
  
  BACKGROUND
  In 1989, the lifetime risk of hip fractures in Canada was 14.0% (women) and 5.2% (men). Since then, there have been changes in rates of hip fracture and increased longevity. We update these estimates to 2008 adjusted for these trends, and in addition, we estimated the lifetime risk of first hip fracture.
  
  
  METHODS
  We used national administrative data from fiscal year April 1, 2007 to March 31, 2008 to identify all hip fractures in Canada. We estimated the crude lifetime risk of hip fracture for age 50 years to end of life using life tables. We projected lifetime risk incorporating national trends in hip fracture and increased longevity from Poisson regressions. Finally, we removed the percentage of second hip fractures to estimate the lifetime risk of first hip fracture.
  
  
  RESULTS
  From April 1, 2007 to March 31, 2008, there were 21,687 hip fractures, 15,742 (72.6%) in women and 5,945 (27.4%) in men. For women and men, the crude lifetime risk was 12.1% (95%CI, 12.1, 12.2%) and 4.6% (95%CI, 4.5, 4.7%), respectively. When trends in mortality and hip fractures were both incorporated, the lifetime risk of hip fracture were 8.9% (95%CI, 2.3, 15.4%) and 6.7% (95%CI, 1.2, 12.2%). The lifetime risks for first hip fracture were 7.3% (95%CI, 0.8, 13.9%) and 6.2% (95%CI, 0.7, 11.7%).
  
  
  CONCLUSIONS
  The lifetime risk of hip fracture has fallen from 1989 to 2008 for women and men. Adjustments for trends in mortality and rates of hip fracture with removing second fractures produced non-significant differences in estimates.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, Faculty of Health Science, McMaster University, Hamilton, ON, Canada. hopkinr@mcmaster.ca
authors.forename: R B
authors.initials: RB
authors.lastname: Hopkins
authors.forename: E
authors.initials: E
authors.lastname: Pullenayegum
authors.forename: R
authors.initials: R
authors.lastname: Goeree
authors.forename: J D
authors.initials: JD
authors.lastname: Adachi
authors.forename: A
authors.initials: A
authors.lastname: Papaioannou
authors.forename: W D
authors.initials: WD
authors.lastname: Leslie
authors.forename: J E
authors.initials: JE
authors.lastname: Tarride
authors.forename: L
authors.initials: L
authors.lastname: Thabane
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology* / Q000401:mortality; D018570:Risk Assessment / Q000379:methods; D017678:Sex Distribution