Gender and Race

Most bone cancers and soft tissue sarcomas are found more frequently in males than females and more frequently among whites than those of any other race, although there are exceptions or outliers to these generalizations for certain subtypes of bone and soft tissue tumors. However, reported rates have varied slightly for both genders and by race for the past decade. The average annual incidence of bone and joint cancers between 2012 and 2016 was 1 in 100,000, a slightly higher rate than reported in the first decade of the 21st century. The rate among white males was 1.2 in 100,000, while, among white females it was 0.9 in 100,000. The lowest reported rate, 0.6/100,000 was found for females of the Asian or Pacific Islander race. The incidence of cancer of the bones and joints in the United States is comparable to several site-specific oral cancers (i.e., lip, salivary gland, floor of the mouth), cancers of the bile duct, cancers of the eye, and Kaposi's sarcoma, which affects the skin and mucous membranes and is often associated with immunodeficient individuals with AIDS. (Reference Table 6A.A.1.1.1 PDF CSV and Table 6A.A.1.3.1 PDF CSV)

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As with bone and joint cancers, males have a higher incidence of myeloma than do females, with an average of 8.1 cases in 100,000 white males to 4.9 cases in 100,000 white females for the years 2012-2016. Blacks have a much higher incidence rate of myeloma than whites, with 16.3 cases in 100,000 black males to 11.9 cases in 100,000 black females for the years 2012-2016 while American Indians/Alaska Natives and Asian/pacific islanders have lower incidence rates. The incidence of myeloma in the United States is comparable to the incidence of esophageal, liver, cervical, ovarian, brain, and lymphocytic leukemia cancers. Death rates reflect incidence. (Reference Table 6A.A.1.2.1 PDF CSV and Table 6A.A.1.2.2 PDF CSV)

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The gender make-up of bone and joint cancers from the most recent NCDB (2004-2015) cohort also shows a male predominance for most of the bone and joint cancers and cancer subtypes, with parosteal osteosarcoma showing the major break from this generalization with 34% male and 66% female patients with this cancer. (Reference Table 6A.B.1.6 PDF CSV and Table 6A.B.1.7 PDF CSV)

Age

The median age for cancers of the bones and joints has risen slightly, to age 43 years, in recent years. However, it remains the leading cause of cancer in young persons under the age of 20 years. More than one in four (26%) diagnoses of bone and joints cancer is in children and youth under the age of 20 years, with 42% of cases diagnosed in persons younger than 35 years. Death from bone and joints cancer also affects children and youth at a high rate, with 12% of deaths occurring in those under 20 years of age and one fourth (27%) in those younger than 35 years. Males are typically diagnosed with bone cancers, and die from bone cancer, at an age several years younger than females. (Reference Table 6A.A.1.3.1 PDF CSV; Table 6A.A.1.4.1 PDF CSV; Table 6A.A.1.7 PDF CSV; and Table 6A.A.1.8 PDF CSV).

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Younger patients have a higher likelihood of surviving bone cancers. For example, the 5-year survivorship for classic osteosarcoma is 67% in 10 to 20-year-old patients, compared to 34% in patients in their 60s, 19% for patients in their 70s, and only 7% in patients in their 80s and older. Similar declining survivorship is noted with increasing age for Ewing Sarcoma and chondrosarcoma (unpublished NCDB current data analysis).

Myeloma, on the other hand, is primarily a cancer found among elderly persons, with a median age of 69 at the time of diagnosis and 75 at time of death from myeloma. Sixty-two percent (62%) of new myeloma cases are diagnosed in persons age 65 years and older, with more than three in four (78%) of deaths due to myeloma occurring in those 65 and older. Again, males are typically diagnosed with myeloma at ages a few years younger than females. (Reference Table 6A.A.1.3.1 PDF CSV; Table 6A.A.1.4.1 PDF CSV; Table 6A.A.1.7 PDF CSV; and Table 6A.A.1.8 PDF CSV)

Race and Ethnicity

The incidence of bone and joints cancers is higher among non-Hispanic whites than found in other race/ethnicity groups, while myeloma is higher in non-Hispanic blacks. Death rates follow the same race/ethnic lines. (Reference Table 6A.A.1.1.1 PDF CSV; Table 6A.A.1.1.2 PDF CSV; Table 6A.A.1.2.1 PDF CSV; and Table 6A.A.1.2.2 PDF CSV)

Causes of health disparities are complex and can include interrelated social, economic, cultural, environmental, and health system factors, and may arise, at least in part, from inequities in work, wealth, education, housing, and overall standard of living, as well as social barriers to high-quality cancer prevention, early detection, and treatment services.1

• 1. American Cancer Society. Cancer Facts & Figures 2017. Cancer disparities, p 49.  https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-... Accessed January 22, 2018.