Hamid Mariya F, Hayden Amy, Moujaber Tania, Turner Sandra, Gurney Howard, Grossmann Mathis, Wong Peter
Westmead Hospital, Sydney, NSW.
Crown Princess Mary Cancer Centre at Westmead Hospital, Sydney, NSW.
Med J Aust. 2023 Feb 20;218(3):126-130. doi: 10.5694/mja2.51835. Epub 2023 Jan 27.
OBJECTIVE: To determine the prevalence in Australia of bone health assessment of men with prostate cancer by dual-energy x-ray absorptiometry (DXA), from six months before to twelve months after initiation of androgen deprivation therapy (ADT). DESIGN, SETTING: Cross-sectional national study; linkage of de-identified Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data. PARTICIPANTS: Men (18 years or older) first dispensed PBS-subsidised ADT during 1 May 2017 - 31 July 2020. MAIN OUTCOME MEASURES: Prevalence of MBS-subsidised DXA assessments undertaken from six months before to twelve months after first ADT prescription. RESULTS: Of 33 836 men with prostate cancer commencing ADT therapy during 2017-20, 6683 (19.8%) underwent DXA bone heath assessments between six months before and twelve months after commencing ADT; the mean time from first ADT dispensing to DXA scanning was +90 days (standard deviation, 134 days). The proportion of men aged 54 years or younger who had scans (66 of 639, 10%) was smaller than that of men aged 70-84 years (4528 of 19 378, 23.4%; adjusted odds ratio, 0.36; 95% CI, 0.28-0.47). CONCLUSIONS: For about 80% of men with prostate cancer commencing ADT in Australia, therapy initiation was not accompanied by DXA assessment of bone health. Given the excellent long term prognosis for men with prostate cancer and the availability of bone protective therapy, bone health monitoring should be a routine component of prostate cancer care for men receiving ADT.
目的:确定在澳大利亚,接受雄激素剥夺疗法(ADT)的前列腺癌男性患者在开始治疗前六个月至治疗后十二个月期间,通过双能X线吸收法(DXA)进行骨健康评估的患病率。 设计、研究地点:全国性横断面研究;将匿名的医疗保险福利计划(MBS)和药品福利计划(PBS)数据进行关联。 研究对象:2017年5月1日至2020年7月31日期间首次获得PBS补贴的ADT药物的18岁及以上男性。 主要观察指标:首次ADT处方前六个月至首次ADT处方后十二个月期间接受MBS补贴的DXA评估的患病率。 结果:在2017 - 2020年开始ADT治疗的33836名前列腺癌男性患者中,6683名(19.8%)在开始ADT前六个月至开始ADT后十二个月期间接受了DXA骨健康评估;从首次ADT配药到DXA扫描的平均时间为+90天(标准差,134天)。54岁及以下接受扫描的男性比例(639人中的66人,10%)低于70 - 84岁男性(19378人中的4528人,23.4%;调整后的优势比,0.36;95%置信区间,0.28 - 0.47)。 结论:在澳大利亚,约80%开始接受ADT治疗的前列腺癌男性患者在开始治疗时未进行DXA骨健康评估。鉴于前列腺癌男性患者的长期预后良好,且有骨保护治疗方法,对于接受ADT的前列腺癌男性患者,骨健康监测应成为前列腺癌护理的常规组成部分。
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