TY - JOUR
T1 - Osteoporosis Amongst Testicular Cancer Survivors
T2 - Long Term Follow-Up of the Veterans Affairs Health System
AU - Yodkhunnatham, Nuphat
AU - Riviere, Paul
AU - Pandit, Kshitij
AU - Morgan, Kylie
AU - Meagher, Margaret
AU - Dabbas, Mai
AU - Nelson, Tyler
AU - Puri, Dhruv
AU - Yuen, Kit
AU - Taylor, Jacob
AU - Herchenhorn, Daniel
AU - Hofflich, Heather
AU - Stewart, Tyler
AU - Javier-Desloges, Juan
AU - Salmasi, Amirali
AU - McKay, Rana R.
AU - Kern, Sean Q.
AU - Millard, Frederick
AU - Rose, Brent
AU - Bagrodia, Aditya
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/6
Y1 - 2025/6
N2 - Introduction: Testicular cancer (TC) is the most common malignancy among young males and is associated with cure rates over 95%. However, the long-term health implications of treatments, such as the risk of osteoporosis, remain inadequately understood. This study aims to explore the incidence of osteoporosis in TC survivors and associated risk factors. Methods: This retrospective study utilized data from the Veterans Affairs (VA) national electronic health record system, identifying 1686 TC patients and 7412 matched noncancer controls. The incidence of osteoporosis was determined through diagnosis codes and osteoporosis medication prescriptions. Statistical analyses, including chi-squared tests, t-tests, and Cox proportional hazards models, were employed to evaluate risk factors. Results: TC survivors exhibited a significantly elevated hazard of developing osteoporosis (HR =2.18; 95% CI, 1.52-3.14; P < .001), which persisted after adjusting for covariates (HR = 1.58; 95% CI, 0.99-2.51; P = .013). There was no significant TC treatment-specific effect: neither radiation nor chemotherapy were associated with an increased hazard of osteoporosis in multivariable analysis. Conclusion: TC survivors face a higher hazard of osteoporosis, with age at diagnosis being a significant factor. These findings highlight the need for regular bone health monitoring in TC survivors. Future prospective studies are necessary to validate these results and better understand the mechanisms linking TC, hypogonadism, and osteoporosis risk.
AB - Introduction: Testicular cancer (TC) is the most common malignancy among young males and is associated with cure rates over 95%. However, the long-term health implications of treatments, such as the risk of osteoporosis, remain inadequately understood. This study aims to explore the incidence of osteoporosis in TC survivors and associated risk factors. Methods: This retrospective study utilized data from the Veterans Affairs (VA) national electronic health record system, identifying 1686 TC patients and 7412 matched noncancer controls. The incidence of osteoporosis was determined through diagnosis codes and osteoporosis medication prescriptions. Statistical analyses, including chi-squared tests, t-tests, and Cox proportional hazards models, were employed to evaluate risk factors. Results: TC survivors exhibited a significantly elevated hazard of developing osteoporosis (HR =2.18; 95% CI, 1.52-3.14; P < .001), which persisted after adjusting for covariates (HR = 1.58; 95% CI, 0.99-2.51; P = .013). There was no significant TC treatment-specific effect: neither radiation nor chemotherapy were associated with an increased hazard of osteoporosis in multivariable analysis. Conclusion: TC survivors face a higher hazard of osteoporosis, with age at diagnosis being a significant factor. These findings highlight the need for regular bone health monitoring in TC survivors. Future prospective studies are necessary to validate these results and better understand the mechanisms linking TC, hypogonadism, and osteoporosis risk.
KW - Bone health
KW - Germ cell tumor
KW - Quality of life
KW - Survivorship
UR - http://www.scopus.com/inward/record.url?scp=105002003547&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2025.102332
DO - 10.1016/j.clgc.2025.102332
M3 - Article
AN - SCOPUS:105002003547
SN - 1558-7673
VL - 23
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 3
M1 - 102332
ER -