Global burden and forecast of malignant neoplasms of bone and articular cartilage from 1990 to 2030

Malignant neoplasms of bone and articular cartilage (MNBAC) are rare but highly lethal cancers, disproportionately affecting children and adolescents. Despite their clinical significance, comprehensive global assessments of their burden and long-term trends remain scarce.

Using Global Burden of Disease (GBD) 2021 data (1990-2021), we estimated age-standardized incidence (ASIR), death (ASDR), and disability-adjusted life years (DALY ASR) across 21 geographic and 5 sociodemographic index (SDI) regions. Temporal trends were quantified with estimated annual percentage change (EAPC). Polynomial regression across 1990-2021 was used to assess the association between SDI and disease burden. Age-sex stratification, age-period-cohort (APC) modeling, and Bayesian APC (BAPC) projections to 2030 were conducted.

Globally, the MNBAC burden modestly increased over three decades. High-SDI regions experienced declining trends, whereas middle- and low-middle-SDI regions showed substantial increases in incidence and mortality. The polynomial regression analysis revealed that there was an overall negative correlation between SDI and disease burden, but a significant nonlinear relationship existed. Adolescents and older adults carried the highest incidence, with males more frequently affected. Cohort analyses revealed increasing risks in middle-SDI populations, and projections indicate a continuing rise in burden in these regions by 2030, while stabilization or decline is expected elsewhere.

Although rare, MNBAC imposes a growing global health burden, particularly in middle-SDI regions and vulnerable populations. Recognizing the nonlinear link between socioeconomic development and disease burden highlights the need for stage-specific strategies, including strengthening early diagnosis, equitable access to care, and targeted prevention strategies is critical to reducing future disparities.