Osteosarcoma, the most common primary bone tumor, occurs most frequently in adolescents, but a second incidence peak among individuals over age 60 exists. Most osteosarcoma epidemiology studies have been embedded in large analyses of all bone tumors, or focused on cases occurring in adolescence. Detailed descriptions of osteosarcoma incidence and survival specifically, with direct comparisons among subjects of all ages and ethnicities, are not available.
Frequency, incidence and survival rates for 3,482 patients with osteosarcoma from the National Cancer Institute’s population-based Surveillance, Epidemiology, and End Results (SEER) program between 1973 and 2004 are presented by age (0–24, 25–59, and 60–85+ years), race, sex, pathology subtype, stage, and anatomic site.
There were large differences in incidence and survival rates by age. Osteosarcoma incidence in the youngest cases was greatest in the Other race designation, while it was greatest in Blacks and Whites in the middle age and elderly patients, respectively. There was a high percentage of osteosarcoma with Paget’s disease and osteosarcoma as a second or greater cancer among the elderly. Tumor site differences among age groups were noted. Survival rates varied by anatomic site and disease stage, and have not significantly improved from 1984 to 2004.
This comprehensive, population-based description of osteosarcoma, identified important differences in incidence, survival, pathologic subtype, and anatomic site among age groups, and quantified the impact of osteosarcoma in Paget’s disease or as a second cancer on incidence and mortality rates. These findings may have implications in understanding osteosarcoma biology and epidemiology.