Are there racial differences in the risk of fractures for patients on ADT?

The conclusion of this paper is simple and straightforward; i.e., ADT increases the risk of bone fractures regardless of race. What is not clear is what might account for a lower incidence of bone fractures for men on ADT in China versus in North America or Europe.

At least one study has reported that Asians have a lower bone mineral density than Caucasians. But, if that were the only thing that mattered, one would not expect the Chinese men to have lower fracture rates. Other things that could account for the difference are lifestyle factors, such as dietary calcium intake, alcohol use and tobacco consumption. One may wonder how much of the difference in fracture rates between Asians and Caucasians would persist if corrections were made based on total body mass, height, and mobility. If there are indeed underlying genetic factors at play here once the other variables are controlled for, that would be interesting to know.


Wu CT, Yang YH, Chen PC, Chen MF, Chen WC. 2015. Androgen deprivation increases the risk of fracture in prostate cancer patients: a population-based study in Chinese patients. Osteoporos Int 26(9):2281-2290.