# Trends and disparities in bone cancer mortality among US adults from 1999 to 2020: a joinpoint regression analysis based on the CDC WONDER database

## TL;DR

Bone cancer mortality in the US increased from 1999 to 2020, with significant differences by age, sex, race, and region.

## Contribution

The study identifies a triphasic trend in bone cancer mortality and highlights disparities across demographic and geographic groups.

## Key findings

- Overall mortality rates increased from 0.528 to 0.599 per 100,000 from 1999 to 2020.
- Males and older adults had higher mortality rates compared to females and younger adults.
- Black or African American individuals had higher mortality rates than White and Hispanic individuals.

## Abstract

This study aims to describe trends in bone cancer-related mortality from 1999 to 2020 and analyze disparities across various demographic subgroups.

Data were obtained from the CDC WONDER multiple cause of death database (1999–2020). Deaths of individuals aged 25 years or older with primary malignant bone cancer (ICD-10 codes C40–C41) as the underlying cause were included. AAMRs were calculated. Joinpoint regression analysis was employed to evaluate temporal trends and estimate the APC and AAPC.

From 1999 to 2020, a total of 25,859 bone cancer deaths were reported among US adults. The overall ASMR increased from 0.528 per 100,000 (95% CI: 0.495–0.562) in 1999 to 0.599 per 100,000 (95% CI: 0.569–0.682) in 2020, with an AAPC of 0.509 (95% CI: 0.196 to 0.931; p = 0.002) over the 22-year period. Joinpoint analysis identified three distinct segments: a non-significant decrease from 1999 to 2014 (APC = –0.218, p = 0.288), a significant increase from 2014 to 2018 (APC = 4.479, p = 0.157), and a non-significant decrease from 2018 to 2020 (APC = –1.779, p = 0.424). Mortality rates were higher in males (0.712 per 100,000) than in females (0.446 per 100,000). Adults aged 85 years and older had the highest mortality rate (3.430 per 100,000). Black or African American individuals experienced a higher mortality rate (0.584 per 100,000) compared to White (0.561 per 100,000) and Hispanic or Latino (0.335 per 100,000) individuals. Geographically, the South had the highest mortality rate (0.614 per 100,000), while the Northeast had the lowest (0.444 per 100,000).

Bone cancer mortality among US adults showed an overall increasing trend from 1999 to 2020, with significant disparities by age, sex, race, and geographic region. The triphasic mortality trend may reflect evolving diagnostic technologies, treatment approaches, and healthcare accessibility. These findings provide valuable insights for public health planning and resource allocation aimed at reducing the burden of bone malignancies.