Incidence of fractures compared to cardiovascular disease and breast cancer: the Women’s Health Initiative Observational Study |
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Authors: | J A Cauley N S Wampler J M Barnhart L Wu M Allison Z Chen S Hendrix J Robbins R D Jackson |
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Institution: | 1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA 2. Noqsi Native Research, Ltd., Pine, CO, 80470, USA 3. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, 10461, USA 4. Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA 5. University of California, San Diego, La Jolla, CA, 92093, USA 6. Division of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, 85716, USA 7. School of Medicine, Wayne State University, Detroit, MI, 48202, USA 8. Department of Internal Medicine, University of California at Davis School of Medicine, Sacramento, CA, 95817, USA 9. Department of Internal Medicine and Physical Medicine, Ohio State University, Columbus, OH, 43210, USA
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Abstract: | Summary 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.
This article is discussed in an editorial that is available at . |
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Keywords: | Breast cancer Cardiovascular disease Fracture Osteoporosis Race/ethnicity Women’ s Health Initiative |
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