Prostate cancer is the commonest solid organ malignancy in men. Approximately half of prostate cancer patients will be treated with ADT, which profoundly suppresses testosterone levels. This leads to an increased risk of fracture. Bisphosphonates and denosumab are effective at preventing ADT-related bone loss. However, bone density is often not assessed by dual x-ray absorptiometry (DXA) in this population, despite guidelines suggesting it should be routinely performed.
AIM: To determine the national prevalence of bone health assessment by DXA scan, in the six months prior to, and 12 months following, dispensation of the first script of ADT for prostate cancer in Australia.
METHODS: An application has been submitted to the Department of Human Services to determine the number of patients who underwent a DXA scan within 6 months i.e., prior to and subsequent to, the initial script of ADT being dispensed for the period Jan 1, 2016- Dec 31, 2019. DXA scans billed under MBS item no. 12312 (male hypogonadism) will be identified. As it is possible some DXA scans may have been done for alternative indications, eg. following low trauma fracture (MBS item no. 12306) or aged > 70 years (MBS item no. 12320, 12322), these will also be identified if performed within 6 months ie., prior to and subsequent to, the initial script of ADT being dispensed for Jan 1, 2016-Dec 31, 2019.
Total patient numbers dispensed ADT under the PBS for prostate cancer will be identified, e.g. leuprorelin (PBS codes 10656W, 8707G, 8708H, 8709J, 8859G, 8875D, 8876E, 8877F) or goserelin (PBS codes 8093Y, 9064C). As MBS item no. 12312 for a DXA scan also covers other indications, eg. prolonged glucocorticoid therapy or excess glucocorticoid secretion or female hypogonadism, linking patients who underwent a DXA scan under this item number and who were prescribed ADT will identify patients who become hypogonadal due to ADT and who underwent a DXA scan.
RESULTS: To be determined.