Prevalence of and Factors Associated with Osteoporosis among Korean Cancer Survivors: A Cross-Sectional Analysis of the Fourth and Fifth Korea National Health and Nutrition Examination Surveys

Background: Identifying and managing osteoporosis among cancer survivors is an important issue, yet littleis known about the bone health of cancer survivors in Korea. This study was designed to measure the prevalenceof osteoporosis and to assess related factors among Korean cancer survivors. Materials and
Methods: Thisstudy was designed as a cross-sectional analysis. Data were obtained from dual energy X-ray absorptiometrymeasurement of the lumbar vertebrae and femoral neck, and from standardized questionnaires among 556cancer survivors and 17,623 non-cancer controls who participated in the Fourth and Fifth Korea NationalHealth and Nutrition Examination Surveys (2008-2011). We calculated adjusted proportions of osteoporosis innon-cancer controls vs. cancer survivors, and we performed multivariate logistic regression analysis.
Results:The prevalence of osteoporosis among cancer survivors was significant higher than that of the non-cancercontrols after adjusting for related factors. Furthermore, osteoporosis among cancer survivors was higher inelderly subjects (60-69 years : adjusted odds ratio (aOR) 3.04, 95% CI : 1.16-8.00, ≥70 years : aOR 6.60, 95%CI 2.20-19.79), in female cancer survivors (aOR: 7.03, 95% CI: 1.88-26.28), and in a group with lower monthlyincome (aOR: 3.38, 95% CI: 1.31-8.71). In male cancer survivors, underweight and lower calcium intake wererisk factors.
Conclusions: These data suggest that the osteoporosis among cancer survivors varies according tonon-oncologic and oncologic factors. Effective screening should be applied, and a sufficient and comprehensivemanagement should be matched to individual cancer survivors early after cancer treatment.