{
  "abstract": "Background\n\nCancer treatment-induced bone loss (CTIBL) is well-recognized in hormone-sensitive malignancies such as breast and prostate cancer but is less consistently implemented in patients with other solid tumors and hematologic malignancies. Furthermore, the long-term skeletal effects of newer systemic therapies, including immune checkpoint inhibitors and targeted agents, remain incompletely characterized. Although bone mineral density (BMD) assessment by dual-energy X-ray absorptiometry (DXA) is recommended for patients at increased skeletal risk, real-world utilization patterns remain poorly characterized.Objectives\n\nTo evaluate DXA utilization, timing, BMD results, and associated clinical characteristics following a new cancer diagnosis in a large real-world cohort.Methods\n\nWe conducted a retrospective cohort study using the MDClone platform, including adults with a first cancer diagnosis between January 1, 2015, and December 31, 2024, treated at Assuta Medical Centers in Israel. DXA completion, timing, BMD and T-scores, and prevalence of osteopenia and osteoporosis were analyzed.Results\n\nAmong 21,112 patients with newly diagnosed cancer (77.0% women; mean age 60.2 ± 13.1 years), 7496 (35.5%) underwent DXA at any time following diagnosis. DXA utilization was significantly lower in men than in women (15.0% vs. 41.7%). Early DXA assessment within 6 months of diagnosis was uncommon (1550 patients; 7.3% of the total cohort), and only 14.1% underwent DXA within the first 12 months. Median time from cancer diagnosis to DXA was 14.8 months. DXA utilization varied by cancer type and was highest in breast cancer (42.2%) and prostate cancer (30.0%), with substantially lower utilization among patients with other malignancies. Among patients with complete evaluable measurements, 40.2% had normal BMD, 45.2% had osteopenia, and 14.5% met criteria for osteoporosis.Conclusions\n\nIn our real-world experience within a large private healthcare network, DXA assessment after cancer diagnosis is infrequently performed and often delayed, with marked disparities by sex and cancer type. A substantial burden of low bone mass is already present at the time of evaluation, highlighting missed opportunities for early skeletal risk identification.",
  "abstract_shown": true,
  "affiliations": [
    "Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky University Medical Center, Tel Aviv, Israel. vanessar@tlvmc.gov.il.",
    "Gray School of Medicine, The Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel. vanessar@tlvmc.gov.il.",
    "Assuta Medical Centers, Tel Aviv, Israel. vanessar@tlvmc.gov.il.",
    "Assuta Medical Centers, Tel Aviv, Israel.",
    "Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky University Medical Center, Tel Aviv, Israel.",
    "Gray School of Medicine, The Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Vanessa Rouach",
      "orcid": "0000-0003-4641-1465"
    },
    {
      "affs": [
        3
      ],
      "name": "Ziv Versano"
    },
    {
      "affs": [
        3
      ],
      "name": "Meital Sasson"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Yona Greenman"
    },
    {
      "affs": [
        3
      ],
      "name": "Arnon Makori"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cav5kqnhbm2cc.bib",
  "cited_by": 0,
  "doi": "10.1007/s00520-026-11340-3",
  "fulltext_url": "https://europepmc.org/articles/PMC13680299",
  "id": "cav5kqnhbm2cc",
  "issns": [
    "0941-4355",
    "1433-7339"
  ],
  "landing_url": "https://europepmc.org/article/MED/42897399",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2730|Bone health and treatments"
    ]
  ],
  "openalex": "W7222917577",
  "pdf_url": "https://europepmc.org/articles/PMC13680299?pdf=render",
  "pmcid": "PMC13680299",
  "pmid": "42897399",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cav5kqnhbm2cc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:32Z",
      "native_id": "MED:42897399",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42897399"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Bone health and treatments",
      "subfield": "oncology"
    }
  ],
  "title": "Delayed and selective bone health assessment following cancer diagnosis: a real-world gap in survivorship care.",
  "title_text": "Delayed and selective bone health assessment following cancer diagnosis: a real-world gap in survivorship care.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:32Z",
  "url": "https://research.draconitic.com/paper/cav5kqnhbm2cc",
  "venue": "Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer",
  "versions": []
}