Osteoporosis knowledge, health beliefs, and self-efficacy in UK men with prostate cancer: a cross-sectional primary care survey.

Abstract

Men with prostate cancer (PC) are at increased risk of fragility fractures due to age, the disease itself, and cancer treatment, such as androgen-deprivation therapy. Despite the burden of fragility fractures on individuals and the healthcare systems, preventative measures are poorly implemented for this patient population. This study aims to explore osteoporosis knowledge, health beliefs, and self-efficacy among men with PC, and how these factors differ across socioeconomic groups. Findings will inform a tailored, integrated bone health intervention for men with PC. A cross-sectional survey was conducted across eight general practices in an urban city in the UK from November 2024 to January 2025. Data collected included sociodemographic information; osteoporosis risk factors; and three validated questionnaires: FOOQ & MOKQ, OHBS, and OSES. Data were analysed using SPSS. Of 516 eligible men,197 responded (38.2% response rate). Participants demonstrated low osteoporosis knowledge (mean scores: 48.2% FOOQ, 33.5% MOKQ), yet showed moderate motivation and belief in the benefits of exercise and calcium. Self-efficacy scores were moderate (OSE-exercise: 69.6; OSE-calcium: 71.4). Men with older age, lower education, and greater deprivation tend to have poorer knowledge and more barriers to exercise. In addition, 19.6% reported falls in the previous 12 months. Men with PC have limited understanding of osteoporosis despite increased risk. Our findings highlight the need for a tailored, person-centred intervention co-produced with patients, to support bone health self-management with practical guidance, and integrated into the primary care pathway for PC.