Summary
This ASCO clinical practice guideline synthesises evidence on osteoporosis management in adult cancer survivors without metastatic disease. Drawing on a 2018 US Preventive Services Task Force review plus 61 additional cancer-specific studies, the panel recommends fracture risk stratification using established tools, bone mineral density testing for high-risk patients, and optimisation of nutrition, exercise and lifestyle. For those requiring pharmacotherapy, bisphosphonates or denosumab at osteoporosis-indicated dosages are advised as preferred interventions.
Regional applicability
This guideline was developed in the United States context and represents international best practice; however, applicability to United Kingdom practice depends on alignment with NICE guidance and NHS treatment availability. UK clinicians should cross-reference with local osteoporosis and oncology guidelines, particularly regarding access to bone-modifying agents and baseline fracture risk assessment protocols in the NHS.
Key measures
Fracture risk assessment tools, bone mineral density testing protocols, pharmacological intervention efficacy and safety
Outcomes reported
The study produced evidence-based clinical practice guidelines for assessing fracture risk and managing osteoporosis in nonmetastatic cancer survivors. Recommendations address fracture risk assessment, bone mineral density testing, and pharmacological interventions including bisphosphonates and denosumab.
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