title: Comparison of fracture risk assessment tool score to bone mineral density for estimating fracture risk in patients with advanced prostate cancer on androgen deprivation therapy.
abstract: OBJECTIVE
  To estimate the risk of fracture (Fracture Risk Assessment Tool [FRAX] algorithm) because of the development of osteoporosis in prostate cancer patients undergoing androgen deprivation therapy (ADT) for patients who would otherwise not have been identified for treatment by the T score.
  
  
  METHODS
  This study includes men undergoing ADT for prostate cancer at our urology group. Clinical data were collected via chart review. Subjects were evaluated for fracture risk using country specific (for the United States of America) World Health Organization's FRAX. The FRAX calculations were then compared to fracture risk as determined by T score, for a subset of our cohort that received dual-energy X-ray absorptiometry.
  
  
  RESULTS
  Our cohort consisted of 613 patients on ADT, 94 of which had a dual-energy X-ray absorptiometry scan. The FRAX algorithm identified 61.6% patients requiring therapy without bone mass density (BMD), 46.8% with BMD, and 19.14% with T score alone. In addition, positive correlation was found between FRAX with and without BMD as well as T score and FRAX with BMD and without BMD.
  
  
  CONCLUSIONS
  Our data indicate that many patients who were not found at significant risk for fracture with T score were in fact found to be at risk with the FRAX calculation. The largest proportion of patients was found to be at risk through the FRAX calculation without BMD, followed by FRAX with BMD, followed by T score alone. The utility of FRAX is beneficial in identifying patients that may benefit from effective bone-tropic treatment modalities.
authors: Associated Medical Professionals of New York, Syracuse, NY.
authors: Herbert
authors: H
authors: James
authors: SUNY Upstate Medical University, Syracuse, NY.
authors: Ilija
authors: I
authors: Aleksic
authors: Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
authors: Marc Nicolas
authors: MN
authors: Bienz
authors: Associated Medical Professionals of New York, Syracuse, NY.
authors: Christopher
authors: C
authors: Pieczonka
authors: Associated Medical Professionals of New York, Syracuse, NY.
authors: Peter
authors: P
authors: Iannotta
authors: Associated Medical Professionals of New York, Syracuse, NY.
authors: David
authors: D
authors: Albala
authors: Associated Medical Professionals of New York, Syracuse, NY.
authors: Neil
authors: N
authors: Mariados
authors: Associated Medical Professionals of New York, Syracuse, NY. Electronic address: vmouraviev@ampofny.com.
authors: Vladimir
authors: V
authors: Mouraviev
authors: Division of Urology, University of Montreal Hospital Center, Montreal, Quebec, Canada.
authors: Fred
authors: F
authors: Saad
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D015519:Bone Density; D018450:Disease Progression; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000037:antagonists & inhibitors; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy / Q000009:adverse effects; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000628:therapy*; D018570:Risk Assessment
chemical_list: D000726:Androgen Antagonists; D007987:Gonadotropin-Releasing Hormone