Abstract
OBJECTIVES:Bone cancers occur frequently in children, adolescents, and young adults aging 15 to 29 years. Osteosarcoma and Ewing sarcoma are the most frequent subtypes in this population. The aim of this study was to describe incidence and mortality trends of bone cancers among Brazilian children, adolescents and young adults.METHODS:Incidence information was obtained from 23 population-based cancer registries. Mortality data were extracted from the Atlas of Cancer Mortality from 1979 to 2013. Specific and adjusted rates per million were analyzed according to gender, morphology and age at diagnosis. Median rates were used as a measure of central tendency. Joinpoint regression was applied to analyze trends.RESULTS:Median incidence rates were 5.74 and 11.25 cases per million in children and young adults respectively. Osteosarcoma in the 15-19 years aged group had the highest incidence rates. Stable incidence rates were observed among five registries in 0-14 year's age group. Four registries had a decreased incidence trend among adolescents and young adults. Median mortality rates were 1.22 and 5.07 deaths per million in children and young adults respectively. Increased mortality was observed on the North and Northeast regions. Decreased mortality trends were seen in the South (children) and Southeast (adolescents and young adults).CONCLUSION:Osteosarcoma and Ewing Sarcoma are the most incident bone cancers in all Brazilian regions. Bone cancers showed incidence and mortality patterns variation within the geographic regions and across age groups, although not significant. Despite limitations, it is crucial to monitor cancer epidemiology trends across geographic Brazilian regions.
Highlights
Bone cancers derive from primitive mesenchymal cells comprising a variety of tumors including osteosarcoma (OS), Ewing sarcoma (ES), chondrosarcoma (CS) and other rarer subtypes
Information about incidence was obtained from 23 populationbased cancer registries (PBCR) covering the five geographic regions of Brazil: North, Northeast, Midwest, Southeast and South that correspond to 23% of the total Brazilian population
The Age-adjusted incidence rates (AAIR) in children was 5.74 cases per million, with highest rates observed in Porto Alegre, Distrito Federal and Curitiba
Summary
Bone cancers derive from primitive mesenchymal cells comprising a variety of tumors including osteosarcoma (OS), Ewing sarcoma (ES), chondrosarcoma (CS) and other rarer subtypes. OS and ES are the most frequent morphological subtypes of bone cancers presenting a worldwide distribution of about 20 to 40% and 6 to 8% of all bone tumors, respectively [3,4]. Received for publication on July 12, 2018. Accepted for publication on January 17, 2019. 80% of patients with ES are younger than 20 years, with the peak incidence occurring during the second decade of life. CS is the most common subtype in older patients [3,5]
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