Demographic analysis of osteosarcoma and ewing sarcoma family of tumours in 0-49 year olds in Great Britain, 1980-2005: A small area approach

Introduction Primary bone cancers (PBC) occur most often in young people. Osteosarcoma and Ewing sarcoma family of bone tumours (ESFT) are the most common sub-groups but aetiology remains unclear. Some childhood cancer rates are known to vary with socioeconomic status. Therefore, this study examined geographical patterning in osteosarcoma and ESFT incidence, diagnosed in 0–49 year olds in Great Britain (GB) during 1980–2005. The analysis focussed on putative associations with area characteristics including deprivation and population density (PD). Methods Data were obtained from all regional cancer registries in GB. Negative binomial regression was used to examine the relationship between incidence rates with PD and Townsend deprivation score (TDS). These models were fitted to small-area census data aggregated by three age bands (0–14, 15–29 and 30–49 years) and gender with the logarithm of the ‘at-risk’ population as an offset. Results There were 2566 osteosarcoma cases and 1650 ESFT cases. After adjustment for age and gender osteosarcoma incidence demonstrated a negative association with TDS (RR for one unit increase in deprivation level =0.975; 95% CI 0.963 to 0.986). ESFT incidence showed a negative association with PD (RR for increase of one person/hectare =0.981; 95% CI 0.972 to 0.989) and non-car ownership (RR for 1% increase of non-car ownership =0.996; 95% CI 0.993 to 1.000). Conclusion More deprived areas have lower osteosarcoma incidence. Higher ESFT incidence is associated with lower PD and higher car ownership levels. Both factors are rural area characteristics. Further study of environmental exposures or land use is recommended.