Risk of fragility fracture of pelvis in endometrial cancer survivors: A national claim database study

Summary: This study investigates the incidence and risk factors of pelvic fragility fractures in endometrial cancer survivors using a national claims database. The incidence was 0.6%, with older age as a significant risk factor. These findings emphasize the need for careful detection and management to improve outcomes. Purpose: This study aimed to evaluate the incidence of fragility fracture of pelvis (FFP) in endometrial cancer survivors and identify associated risk factors using data from the Korean National Claims Database. Methods: A total of 6923 endometrial cancer patients were identified between 2007 and 2016 using data from the linkage between the Korea National Health Insurance Service and Korea Central Cancer Registry. The incidence of FFP was estimated and risk factors, such as age, radiation therapy (RT) status, medical institution type, residential area, income level, insurance type, and comorbidities, were assessed using a Cox proportional hazards regression. Results: The overall incidence of FFP was 0.6%, with a higher incidence in patients who underwent RT (0.8%) compared to those who did not (0.5%). However, the difference was not statistically significant (P = 0.355). Older age was significantly associated with an increased risk of FFPs (adjusted HR = 1.101, 95% CI 1.066–1.138; P < 0.001). Conclusions: The incidence of FFP in endometrial cancer survivors was 0.6%, with a slightly higher rate in those who received RT. Older age was a significant risk factor of FFP. These findings emphasize the need for careful detection and management of FFP, particularly in older patients, to improve long-term outcomes in endometrial cancer survivors.