About one in five men with prostate cancer had osteoporosis in pooled data, and two in five had low bone mass

The edition in brief

A meta-analysis of 52 studies including 91,913 men with prostate cancer found a pooled osteoporosis prevalence of 22.0% and low bone mass in 41.7%, with very high heterogeneity and no assessment of fractures or of any screening or treatment. A study of 2,499 men with grade group 2 to 4 prostate cancer who had prostatectomy found that those with less than 2 mm of Gleason pattern 4 had adverse pathology in about 5% and 5-year biochemical recurrence in about 20%, similar to favourable intermediate-risk disease, suggesting a surveillance threshold that needs validation. A sub-analysis of 1,685 men from the Göteborg-2 screening trial with a negative MRI found 7-year clinically significant cancer incidence of 5.5% with PSA density below 0.10 against 13.8% and 11.9% in higher bands. A retrospective study of 267,133 US veterans with microhaematuria found a 2-year bladder cancer incidence of 1.5%, with a risk model slightly outperforming current guideline stratification (AUC 0.63 vs 0.52). A secondary analysis of STAMPEDE found fewer fracture-related hospitalisations with abiraterone in metastatic disease (22% vs 30% at 5 years). The pearl restates the work-up for visible haematuria.