Incidence of fractures compared to cardiovascular disease and breast cancer: the Women's Health Initiative Observational Study
J A Cauley, N S Wampler, J M Barnhart, L Wu, M Allison, Z Chen, S Hendrix, J Robbins, R D Jackson, Women's Health Initiative Observational Study, Elizabeth Nabel, Jacques Rossouw, Shari Ludlam, Linda Pottern, Joan McGowan, Leslie Ford, Nancy Geller, Ross Prentice, Garnet Anderson, Andrea LaCroix, Charles L Kooperberg, Ruth E Patterson, Anne McTiernan, Sally Shumaker, Evan Stein, Steven Cummings, Sylvia Wassertheil-Smoller, Jennifer Hays, JoAnn Manson, Annlouise R Assaf, Lawrence Phillips, Shirley Beresford, Judith Hsia, Rowan Chlebowski, Evelyn Whitlock, Bette Caan, Jane Morley Kotchen, Barbara V Howard, Linda Van Horn, Henry Black, Marcia L Stefanick, Dorothy Lane, Rebecca Jackson, Cora E Lewis, Tamsen Bassford, Jean Wactawski-Wende, John Robbins, F Allan Hubbell, Howard Judd, Robert D Langer, Margery Gass, Marian Limacher, David Curb, Robert Wallace, Judith Ockene, Norman Lasser, Mary Jo O'Sullivan, Karen Margolis, Robert Brunner, Gerardo Heiss, Lewis Kuller, Karen C Johnson, Robert Brzyski, Gloria E Sarto, Denise Bonds, Susan Hendrix, J A Cauley, N S Wampler, J M Barnhart, L Wu, M Allison, Z Chen, S Hendrix, J Robbins, R D Jackson, Women's Health Initiative Observational Study, Elizabeth Nabel, Jacques Rossouw, Shari Ludlam, Linda Pottern, Joan McGowan, Leslie Ford, Nancy Geller, Ross Prentice, Garnet Anderson, Andrea LaCroix, Charles L Kooperberg, Ruth E Patterson, Anne McTiernan, Sally Shumaker, Evan Stein, Steven Cummings, Sylvia Wassertheil-Smoller, Jennifer Hays, JoAnn Manson, Annlouise R Assaf, Lawrence Phillips, Shirley Beresford, Judith Hsia, Rowan Chlebowski, Evelyn Whitlock, Bette Caan, Jane Morley Kotchen, Barbara V Howard, Linda Van Horn, Henry Black, Marcia L Stefanick, Dorothy Lane, Rebecca Jackson, Cora E Lewis, Tamsen Bassford, Jean Wactawski-Wende, John Robbins, F Allan Hubbell, Howard Judd, Robert D Langer, Margery Gass, Marian Limacher, David Curb, Robert Wallace, Judith Ockene, Norman Lasser, Mary Jo O'Sullivan, Karen Margolis, Robert Brunner, Gerardo Heiss, Lewis Kuller, Karen C Johnson, Robert Brzyski, Gloria E Sarto, Denise Bonds, Susan Hendrix
Abstract
To compare the absolute risk of fracture to the risk of other conditions by race/ethnicity, we studied 83,724 women, aged 70-79. The projected number of fractures was similar to or exceeded the combined number of cardiovascular events and breast cancers. Osteoporosis prevention efforts should target women of all ethnicities.
Introduction: The relative risk of fracture is lower in non-white compared to white women but the absolute risk of fracture in comparison to other common chronic conditions is uncertain.
Methods: We performed a prospective cohort study of 83,724 women, age 50-79 years. Cardiovascular disease (CVD), invasive breast cancer and all fractures were identified over an average of 7.7 +/- 2.6 years.
Results: The incidence of fracture, breast cancer, stroke and CVD varied across ethnicity. The annualized (%) incidence of fracture was greatest in whites (2.4%) and American Indians (2.8%) and lowest among blacks (1.3%). The majority of hip fractures occurred in white women. The projected number of women who will experience a fracture in one year exceeded the combined number of women who would experience invasive breast cancer or a broad category of CVD events in all ethnic groups except blacks. In 10,000 black women, an estimated 153 women would experience CVD, and 35 women, breast cancer compared to 126 women expected to fracture in one year.
Conclusion: The annual risk of suffering a fracture is substantial in women of all ethnicities. Osteoporosis prevention efforts should target all women irrespective of their race/ethnic backgrounds.
Conflict of interest statement
Conflicts of interest Dr. Cauley has received research support from Merck & Company, Eli Lilly & Company, Pfizer Pharmaceuticals and Novartis Pharmaceuticals. She has also received consulting fees from Eli Lilly & Company, and Novartis Pharmaceuticals. Dr. Robbins reports that he has worked on grants with industry support but that he has received no salary support. Dr. Jackson has received research support from and is on the speaker’s bureau for Procter & Gamble Pharmaceuticals, has received research and conference support from Novartis, and has received an honorarium as a Continuing Medical Education speaker for Aventis/Alliance for Better Bone Health. Drs. Wampler, Barnhart, Allison, Chen, Hendrix and Ms. Wu, have no conflicts to report.
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Source: PubMed