Design: Systematic review and meta-analysis of prevalence (52 studies)
Population: 91,913 men with prostate cancer at all stages
Primary outcome: Pooled prevalence of osteoporosis and low bone mass
Effect: Osteoporosis 22.0% (95% CI 19.9-24.1); low bone mass 41.7% (36.6-46.9)

Androgen-deprivation therapy accelerates bone loss, yet bone health is easy to overlook in a cancer clinic focused on the tumour. This meta-analysis pooled 52 studies and 91,913 men with prostate cancer across all stages to quantify how common low bone density is.

The pooled prevalence of osteoporosis was 22.0% (95% CI 19.9 to 24.1) and of low bone mass 41.7% (36.6 to 46.9); together, a majority of men had below-normal bone density. Heterogeneity was very high and was driven mostly by differences in how bone density was measured and defined rather than by true clinical variation, so the exact figures should be read as approximate.

For orthopaedic and shared care the message is to treat these men as a bone-health population: ensure bone density is assessed, especially before and during androgen-deprivation therapy, address calcium, vitamin D, weight-bearing activity and fall risk, and coordinate bone-protective treatment with oncology. In India, where densitometry access is uneven, identifying who most needs a scan matters.

Across 91,913 men with prostate cancer, osteoporosis prevalence was 22.0% and low bone mass 41.7%.
Most men had below-normal bone density, a group frequently on bone-depleting androgen-deprivation therapy.
Assess bone density around starting androgen-deprivation therapy, and address calcium, vitamin D, activity and falls.
Coordinate bone-protective treatment with oncology rather than assuming someone else owns it.
Where densitometry is limited, prioritise men on or starting androgen-deprivation therapy.

Why it matters

It quantifies a bone-health burden that sits between oncology and orthopaedics and so is easily left unmanaged.

The statistics, in plain English

The prevalence estimates carry very high heterogeneity (I-squared over 95%) arising mainly from differing measurement methods, so the pooled percentages are indicative rather than precise; the study measured only how common low bone density is, not whether screening or treatment prevents fractures.