Epidemiology data from population-based cancer registries (PBCR) can be very valuable in the development of health policy and for improving the quality of cancer control strategies.
This study analyzed the incidence of bone sarcomas in Thailand during 2001 – 2015 by analyzing data obtained from 5 PBCRs across country. Incidence rates per million person-years by sex, histological subtype, primary site and 5-year age group were calculated. Age-standardized incidence rates (ASR) were adjusted using the WHO’s World Standard Population and comparisons between populations were done using standardized rate ratios (SRR). Incidence trends were evaluated using Joinpoint Trend Analysis. Survival rates were analyzed using STATA.
The ASR of bone sarcomas in Thailand was 5.1/10 6 person-years, with an estimated 328 newly diagnosed bone sarcomas per year for the country overall. Osteosarcoma (52.5%), chondrosarcoma (18%), Ewing’s sarcoma (11.6%), giant cell tumor (4.8%) and chordoma (4.7%) were the most common malignant bone tumors, representing 91.5% of all bone sarcomas. Bone sarcoma has a predilection for males (1.29:1) and an age-specific bimodal rate pattern closely related to the major histological subtypes, osteosarcoma. One- and five-year survival rates of Thai patients with bone sarcoma were 74% and 52%, respectively. Survival rates of bone sarcomas, particularly osteosarcoma, were lower than the rates reported from the United States, Europe and Japan.
The lower overall survival rate of bone sarcoma represented the gap of bone sarcoma control program in Thailand. That indicates the need for improvement in health promotion, treatment process and chemotherapy for bone sarcoma patients in the future.
- • This study is the first report of bone sarcoma epidemiology in Thailand.
- • The analysis using PBCRs supports the global picture of rare cancers.
- • Osteosarcoma is the most common malignant bone tumors in Thailand (52.6%).
- • The survival rate of bone sarcoma patients is relatively poorer in Thailand.
- • These suggest a gap exists in the areas of health policy in Thailand.
A sarcoma is a solid malignant tumor originating from mesenchymal cells that arises in visceral organs, connective tissue, bone or cartilage. Sarcomas represent about 1% of all malignant tumors . Bone sarcomas are a group of sarcomas which have a high heterogeneity in their histological and molecular profiles. Sarcomas have unique clinical presentations based on the natural history of the subtype and the location of origin on the human skeleton. Increasing survival rates of bone sarcoma patients has been a medical challenge. Epidemiological study of sarcomas represents a fundamental step in improving the quality of treatment as well as developing health policy. The availability of country level reliable and standardized data allows qualitative comparison in several dimensions, including treatment outcomes. A number of factors associated with that data are potentially associated with the risk of disease, e.g., population behavior, ethnicity, and environmental exposure.
Previous national level studies which reported on the incidence of childhood cancer were conducted using three population-based cancer registry (PBCRs) reports covering the periods 1988–1991 , 1995–1997 , and 2003–2005 . In those reports, the incidence of bone sarcomas was reported as a part of childhood cancer, but there were no epidemiology studies focusing specifically on bone sarcoma. The overall incidence of bone sarcoma in those studies was relatively low when compared with population-based series from other areas. The low incidence might have resulted from under-registration or from maturation of the registration process . The incidence and survival rate of childhood osteosarcoma have been reported for the period of 1985–2010 in Khon Kaen . Additionally, the incidence rate and survival rate of bone sarcoma patients in Northern Thailand of all ages, which was analyzed from PBCRs of Chiang Mai and Lampang centers covering a population of 5.9 million during 1998–2012, were reported .
This study analyzed the incidence rate of bone sarcoma in Thailand. Population-based cancer registry data was collected from five cancer registry centers in different regions of the country for the period 2001 through 2015. The overall epidemiology of bone sarcomas and of specific histological subtypes was studied including incidence rate, age, sex, anatomical site, and survival rate. This fundamental data can help describe the overall quality of health care services in the country and can also suggest possible gaps where improvements in medical care are needed.