Optimising Bone Health Care in Cancer Survivorship

Cancer survivorship is rapidly increasing, with more than 70% of Australians now living at least five years after diagnosis and 64% living longer than 10 years. However, many cancer therapies accelerate bone loss and substantially increase the risk of osteoporosis and fractures. Fractures in cancer survivors are associated with increased mortality, chronic pain, loss of independence and high healthcare utilisation. Despite this, bone health is not systematically integrated into cancer care pathways across Australian health services. This project will survey 500 Australian adults who have been diagnosed with cancer to understand whether their bone health is being monitored, what treatments they receive, their knowledge of bone health, and the barriers they face in accessing care. Participants will be recruited through major health services, including Monash Health, Sunshine Coast University Private Hospital, Central Coast Haematology. The results will identify gaps in care and groups at highest risk of preventable fractures. Working with clinicians and cancer survivors, we will translate these findings into practical strategies such as improved screening pathways, patient education resources and survivorship care models. This project directly responds to the growing number of people living with and beyond cancer and will help health services prevent fractures, reduce hospital admissions and improve long-term quality of life. This is a health-service–embedded project with direct translation into practice through the co-development of clinical pathway recommendations for survivorship clinics, targeted education resources for patients and clinicians, and the identification of priority populations for intervention. The collaborative structure across Monash Health and oncology and haematology services in Queensland and New South Wales enables cross-health-service and cross-state comparisons to quantify variation in care and inequities in access to bone health management. These data will provide health services with actionable evidence to inform service planning, prioritise high-risk groups and implement equitable, value-based survivorship care. The outputs will be immediately implementable within participating services and scalable across the Monash Partners network and nationally, forming the platform for subsequent implementation and intervention studies.