A statistical study of sarcoma complicating Paget's disease of bone in three countries

Details of sex, age at presentation and anatomical site of sarcoma complicating Paget's disease of bone were recorded from the literature for white patients in Australia, the United Kingdom and the United States over the period 1978--77. Evidence is presented to suggest that sex and tumour-site distributions are free from bias, except possibly for the skull. There was a male predominance for all sites except the skull, where the odds ratio of sarcoma compared with other locations is more than twice as high for females as for males. No national differences emerged in the sex ratio of patients. In Australia a latitudinal effect was observed. Whereas the percentage of males with uncomplicated Paget's disease was essentially constant, those with sarcoma showed a decrease with increase in latitude from Queensland to Victoria. This was attributable to tumours of the skull. Patients with bone involvement above the waist were significantly younger than those with affected feet, legs or pelvic girdle.