Abstract
BACKGROUND: Bone cancer exhibits significant global disparities in incidence and mortality. Understanding these trends is essential for identifying high-risk populations and informing targeted interventions. METHODS: Using data from the Global Burden of Disease Study 2021 (GBD 2021) and the Cancer Incidence in Five Continents (CI5) database, this study analyzed bone cancer incidence (1993-2017) and mortality (1980-2021) trends. Age-standardized incidence rates (ASRs, per 100,000) and mortality rates were assessed across regions, countries, income levels, and health systems, focusing on gender differences and healthcare capacity. RESULTS: Bone cancer ASRs (1993-2017) ranged from 0.53 to 2.72 for females (China: Yunmeng County, 2.72 [2.16-3.28]) and 0.90-4.28 for males (China: Xiangfu District, 4.28 [3.25-5.31], p < 0.0001), with minimal rates near zero like Brazil: Jau and USA: Hawaii Chinese. Mortality rates (1980-2021) peaked in Eastern Europe and Central Asia, with male rates up to 2.90 (Romania, 2.90 [1.89-3.90], 1980) and female rates up to 2.34 (Greece, 2.34 [2.11-2.58], 1980), while high-income regions like Western Europe declined to 0.84 (males, 0.84 [0.76-0.90], 2021). By 2021, Upper Middle-Income countries (1.26 [0.85-1.62] for males) and Basic Health Systems (1.27 [0.85-1.59] for males) showed rising mortality, surpassing Advanced Health Systems (0.76 [0.71-0.81] for males), reflecting healthcare disparities. Thailand (males, 2.06 [1.18-3.01], 2021) and China saw increasing rates, unlike stable low rates in the USA (males, 0.71 [0.67-0.74], 2021). CONCLUSIONS: Bone cancer incidence and mortality are heavily influenced by healthcare system capacity and socioeconomic factors.