Age-Period-Cohort Analysis of Primary Bone Cancer Incidence Rates in the United States (1976–2005)

Abstract

Background: Primary bone cancer comprises three major histologic types: osteosarcoma (OS), Ewing sarcoma (ES), and chondrosarcoma (CS). Given the limited knowledge about the etiology of primary bone cancer, we undertook an age-period-cohort (APC) analysis to determine whether incidence varied by birth cohort or calendar period. The purpose was to examine the temporal development of each bone cancer type and generate etiologic hypotheses via the observed birth cohort-related changes.Methods: An APC model was fitted to incidence data for U.S. whites for OS, ES, and CS obtained from nine registries of the Surveillance, Epidemiology, and End Results program, which covers about 10% of the U. S. population, 1976-2005.Results: The incidence of OS decreased between 1976 and 2005 among those aged over 60 years, a decline that occurred among patients with OS as their primary malignancy only. From 1986From -1995From to 1996From -2005, the incidence rate of CS among females of 20 to 69 years rose by about 50%, with rates increasing among consecutive cohorts born during . CS rates among males were stable, as were rates of ES.Conclusion: The risk reduction in OS as a primary malignancy at older ages could possibly be related to diminished exposure over time to bone-seeking radionuclides. The CS increase among females corresponds to birth cohorts with rising exposures to oral contraceptives and menopausal hormonal therapy.Impact: As the estrogen signaling pathway has been shown to stimulate proliferation of normal and malignant chondrocytes, estrogen exposure may increase the risk for CS. Further studies are warranted to clarify its possible etiological significance. Cancer Epidemiol Biomarkers Prev; 20(8); 1770-7. Ó2011 AACR.

Increased survival of patients aged 0‐29 years with osteosarcoma: A period analysis, 1984‐2013

“…It was originally reported that males were affected with osteosarcoma more frequently than females 1, 15, 16, 17. However, recent reports suggested that the osteosarcoma incidence may be equal in both sexes 18, 19. This finding was consistent with our study that the males shared the similar incidence with the females in the last decade.…”

Bone cancer incidence by morphological subtype: a global assessment

“…It may thus be postulated that a low incidence of Paget disease (e.g., in Japan) [36] combined with better cancer treatment over the past decades (thereby reducing late effects due to chemotherapy and radiotherapy) may have been important factors in lower incidence of OS later in life [4]. Anfinsen et al [32] have reported age-period-cohort analysis of US data for bone cancers where a decline in incidence rates of OS in the USA during 1976-2005 among those over 60 years (cohorts born during 1905-1934) was seen. This observation, representing the second peak of the bimodal age-incidence curve of OS and a peak incidence around 70 years of age, can be extended to the UK in both sexes, but in this analysis, such a trend was not evident among US women.…”

“…Furthermore, estrogen has been shown to stimulate vascular endothelial growth factor, which is a characteristic trait of progression of CS [16]. Anfinsen et al [32] have reported an increase in incidence rates of CS among females in the USA during 1976-2005 (although no change in incidence among men was seen). The declining cohort trends among US women born during 1935-1975 are replicated for UK women in this study, corresponding to the introduction of exogenous estrogen exposures (oral contraceptives, hormone therapy) in the 1960s.…”

“…stata-journal.com/sjpdf.html?articlenum=st0211) in Stata [31]. As in a previous analysis, concerns regarding the data quality in the elderly for ES and the relatively sparse numbers of cases meant that modeling analyses were restricted to ages 0-64 years for ES; for the other histologic types, the age range was 0-84 years [32].…”

MK1775, a Selective Wee1 Inhibitor, Shows Single-Agent Antitumor Activity against Sarcoma Cells

“…Approximately 10 percent of children with cancer are diagnosed with sarcomas, compared to 8 percent for young adults and 1 percent of adults (>40yrs old) diagnosed with cancer. Ewing sarcoma, osteosarcoma and rhabdomyosarcoma constitute about three quarters of all children with sarcomas whereas liposarcoma, leiomyosarcoma, undifferentiated sarcomas, synovial sarcoma and MPNST represent some of the more common histologies in the adult population (32, 33). Localized sarcomas are frequently treated with multimodal therapy including surgery, radiation therapy and anthracycline based chemotherapy with curative intent.…”