Abstract
BackgroundThe aetiology of bone cancers is poorly understood. This study examined geographical patterning in incidence of primary bone cancers diagnosed in 0–49 year olds in Great Britain during 1980–2005 to provide information on factors linked with disease development. We investigated putative associations with deprivation and population density.MethodsData on osteosarcoma and Ewing sarcoma were obtained from national population-based registries. Negative binomial regression was used to examine the relationship between incidence rates and the Townsend deprivation score (and its component variables) and small-area population density.ResultsThe study analyzed 2566 osteosarcoma and 1650 Ewing sarcoma cases. For females with osteosarcoma, statistically significant decreased risk was associated with higher levels of deprivation (relative risk [RR] per unit increase in deprivation score = 0.969; 95% confidence interval [CI] 0.946–0.993). For all Ewing sarcoma combined, statistically significant decreased risk was associated with greater area-level population density and higher levels of non-car ownership (RR per person per hectare increase = 0.984; 95% CI 0.976–0.993, RR per 1% increase in non-car ownership = 0.994; 95% CI 0.991–0.998).ConclusionsHigher incidence of osteosarcoma was observed for females in areas with lower deprivation levels indicating increased risk is linked to some aspect of affluent living. Higher incidence of Ewing sarcoma occurred in areas of low population density and where more people owned cars, both characteristic of rural environments. The study adds substantially to evidence associating Ewing sarcoma risk with rural environmental exposures. Putative risk factors include agricultural exposures, such as pesticides and zoonotic agents.
Highlights
The aetiology of bone cancers is poorly understood
Geographical or socio-demographic variation in risk is especially indicative of an environmental component to aetiology, which may be associated with gene environment interactions. In light of these previous findings, the aim of the present study was to test predictions of spatial variation occurring among osteosarcoma and Ewing sarcoma that might arise as a result of environmental mechanisms related to area-level population density and area-level socio-economic deprivation
The ratio of the agestandardized incidence rates (ASRs) for males: females was 1.3 and this remained constant over the study period (P = 0.415)
Summary
The aetiology of bone cancers is poorly understood. This study examined geographical patterning in incidence of primary bone cancers diagnosed in 0–49 year olds in Great Britain during 1980–2005 to provide information on factors linked with disease development. One recent analysis of childhood incidence data (aged 0–14 years) from the whole of Great Britain (GB) has found space-time clustering amongst cases of osteosarcoma, but not Ewing sarcoma. Space-time clustering was statistically significant for female cases of osteosarcoma, but not for male cases [7]. This was interpreted as providing support for the involvement of a geographically heterogeneous and intermittent environmental exposure in the aetiology of osteosarcoma. Another analysis of the same GB data set found increased risk of childhood Ewing sarcoma in areas of greater socio-economic affluence [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
