Quality Care 2019: BMD Testing in Men Initiating Hormone Therapy for Prostate Cancer
Posted: Wednesday, September 18, 2019
According to a Canadian population study presented at the 2019 American Society of Clinical Oncology (ASCO) Quality Care Symposium (Abstract 38) in San Diego, men beginning androgen-deprivation therapy (ADT) to treat advanced prostate cancer had low rates of baseline bone mineral density (BMD) testing, although the rates of testing did increase over time. In the Quebec-based study, Alice Dragomir, PhD, of McGill University, Montreal, and colleagues identified possible patient populations in need of appropriate BMD testing, as the timeline may be accelerated when patients are undergoing ADT treatment.
“Potential gaps identified in baseline BMD testing include older, more comorbid patients, and rural residence,” the authors concluded. “Additional efforts emphasizing the importance of BMD testing in advanced prostate cancer guidelines may be needed.”
The investigators utilized the Quebec public health-care insurance administrative databases to identify men who were diagnosed with advanced prostate cancer from 2001 to 2012 and received ADT for at least 1 continuous year. From that time span, the authors identified 7,069 patients, of whom 887 (12.6%) received baseline BMD testing.
The authors found that BMD testing varied according to the year that patients began ADT. From 2001 to 2003, 7.7% of patients were tested, whereas from 2012 to 2013, 12.3% of patients were screened. Following multivariable analyses, Dr. Dragomir and colleagues found that the later years of the study (from 2004 onward) were associated with higher odds of baseline testing compared with the early years (2001–2003), with odds ratios ranging from 1.43 to 1.88.
Conversely, the authors noted, men aged 81 and older were less likely to receive baseline testing (odds ratio = 0.73), as well as men with greater Charlson Comorbidity Index scores (odds ratio = 0.51), and men living in rural residences (odds ratio = 0.60).
Disclosure: The study authors’ disclosure information may be found at coi.asco.org.