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Cancer I
The epidemiology of bone cancer diagnosed in 0–49-year-olds in northern England, 1981–2002
  1. R. G. Feltbower1,
  2. R. Eyre2,
  3. P. W. James2,
  4. K. Blakey2,
  5. E. Mubwandarikwa2,
  6. D. Forman3,4,
  7. P. A. McKinney1,
  8. M. S. Pearce2,
  9. R. J. Q. McNally2
  1. 1
    Paediatric Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK
  2. 2
    Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  3. 3
    Northern and Yorkshire Cancer Registry and Information Service, Bexley Wing, St James’s University Hospital, Leeds, UK
  4. 4
    Cancer Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK

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    Aims

    We aimed to describe incidence and survival patterns for bone cancers diagnosed during 1981–2002 in northern England among 0–39-year-olds.

    Methods

    509 cases with a malignant bone tumour were included the analysis and classified using the International Classification of Diseases for Oncology, second edition. Incidence trends were analysed using Poisson regression. Survival rates were calculated using Kaplan–Meier estimation and differences in survival between diagnostic groups assessed using log-rank tests. Cox regression analysis was used to model the probability of survival in relation to age, gender and year of diagnosis.

    Results

    Overall incidence (per million person years) rates were 3.0 (95% CI 2.6 to 3.4) for osteosarcoma, 2.1 (1.8 to 2.5) for Ewing sarcoma and 0.8 (0.6 to 1.0) for chondrosarcoma. Incidence of osteosarcoma increased significantly by an average annual rate of 2.6% (p = 0.02) although there was no change in incidence for Ewing sarcoma or chondrosarcoma. Survival improved for Ewing sarcoma (hazard ratio (HR) per annum 0.97, 95% CI 0.94 to 1.00), although patients aged 15–39 years (n = 93) had worse overall survival than those aged 0–14 (n = 73) (HR 1.46, 95% CI 0.98 to 2.17). There was no improvement in osteosarcoma survival (HR per annum 0.98, 95% CI 0.95 to 1.01).

    Conclusions

    Our data suggested that incidence of osteosarcoma increased significantly in contrast to other bone tumours among 0–39-year-olds and previous findings from the UK and USA. Poorer survival in older Ewing sarcoma patients is consistent with previous studies and may be due to treatment, delays in diagnosis, metastatic disease, site and the stage of the tumour. The failure to improve survival for osteosarcoma patients needs further investigation.

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