骨折风险评估工具 (FRAX) 是一种骨折风险预测工具，可预测一般人群中重大骨质疏松性骨折 (MOF) 和髋部骨折的 10 年概率。 FRAX 对癌症患者是否有用尚不确定。旨在确定 FRAX 在预测癌症患者骨折事件方面的性能。这项基于人群的回顾性队列研究包括加拿大曼尼托巴省的居民，包括 1987 年至 2014 年诊断出癌症和未诊断出癌症的居民。诊断是通过马尼托巴癌症登记处确定的。基于人群的医疗保健数据确定了截至 2021 年 3 月 31 日的骨折事件。数据分析发生在 2023 年 1 月至 3 月之间。FRAX 评分是根据马尼托巴 BMD 登记处记录的骨矿物质密度 (BMD) 结果计算的。这项研究包括 9877 名癌症患者（平均 [SD] 年龄，67.1 [11.2]岁；8693 [88.0%] 女性）和非癌症队列中的 45877 名个体（平均 [SD] 年龄，66.2 [10.2] 岁；41656 [90.8%] 女性）。与未患癌症的人相比，患有癌症的人的 MOF 发生率更高（每 1000 人年 14.5 例 vs 12.9 例；P<0.001）和髋部骨折发生率更高（每 1000 人年 4.2 例 vs 3.5 例；P =0.002）。在癌症队列中，FRAX 与 BMD 结果与 MOF 事件（每 SD 增加的 HR，1.84 [95% CI，1.74-1.95]）和髋部骨折（每 SD 增加的 HR，3.61 [95% CI，3.13-4.15]）相关。 ）。在癌症队列中，FRAX 与 BMD 的校准斜率对于 MOF 为 1.03，对于髋部骨折为 0.97。 在这项回顾性队列研究中，FRAX 与 BMD 在预测癌症患者骨折事件方面表现出良好的分层和校准。这些结果表明，FRAX 与 BMD 可以成为预测癌症患者骨折事件的可靠工具。

The Fracture Risk Assessment Tool (FRAX) is a fracture risk prediction tool for 10-year probability of major osteoporotic fracture (MOF) and hip fracture in the general population. Whether FRAX is useful in individuals with cancer is uncertain.To determine the performance of FRAX for predicting incident fractures in individuals with cancer.This retrospective population-based cohort study included residents of Manitoba, Canada, with and without cancer diagnoses from 1987 to 2014. Diagnoses were identified through the Manitoba Cancer Registry. Incident fractures to March 31, 2021, were identified in population-based health care data. Data analysis occurred between January and March 2023.FRAX scores were computed for those with bone mineral density (BMD) results that were recorded in the Manitoba BMD Registry.This study included 9877 individuals with cancer (mean [SD] age, 67.1 [11.2] years; 8693 [88.0%] female) and 45 877 individuals in the noncancer cohort (mean [SD] age, 66.2 [10.2] years; 41 656 [90.8%] female). Compared to individuals without cancer, those with cancer had higher rates of incident MOF (14.5 vs 12.9 per 1000 person-years; P < .001) and hip fracture (4.2 vs 3.5 per 1000 person-years; P = .002). In the cancer cohort, FRAX with BMD results were associated with incident MOF (HR per SD increase, 1.84 [95% CI, 1.74-1.95]) and hip fracture (HR per SD increase, 3.61 [95% CI, 3.13-4.15]). In the cancer cohort, calibration slopes for FRAX with BMD were 1.03 for MOFs and 0.97 for hip fractures.In this retrospective cohort study, FRAX with BMD showed good stratification and calibration for predicting incident fractures in patients with cancer. These results suggest that FRAX with BMD can be a reliable tool for predicting incident fractures in individuals with cancer.