European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2026
Trends and future of the disease burden of malignant neoplasms of bone and articular cartilage in China from 1990 to 2023: An analysis based on the Global Burden of Disease 2023.
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Zheng Jianhu, Yu Wenlong, Lou Yan, He Xiaojian, He Shaohui, Zhou Hanhao, Gao Xin, Sun Weidong, Fang Bin, Wang Shuqiang, Yin Mengchen
Аннотация
BACKGROUND: Malignant neoplasms of bone and articular cartilage (MNBAC) are rare but highly aggressive tumors that impose substantial health and socioeconomic burdens. This study aimed to comprehensively assess temporal trends, demographic patterns, and future projections of MNBAC burden in China from 1990 to 2023.
METHODS: Data were obtained from the Global Burden of Disease Study 2023. We analyzed incidence, prevalence, deaths, and disability-adjusted life years (DALYs), along with age-standardized rates. Joinpoint regression was used to estimate annual percent change (APC) and average annual percent change (AAPC). Age-period-cohort (APC) models were applied to evaluate age, period, and cohort effects. A decomposition analysis quantified the contributions of population growth, population aging, and changes in age-specific rates. Bayesian age-period-cohort (BAPC) models were used to project trends through 2040.
RESULTS: From 1990 to 2023, incident cases, prevalent cases, and deaths increased approximately threefold, while DALYs increased by 1.8-fold. The age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) increased by 125.71% and 134.62%, with AAPCs of 2.63% and 2.78%, respectively. In contrast, the age-standardized DALYs rate (ASDR) and age-standardized mortality rate (ASMR) increased by 59.21% and 69.64%, with comparatively lower AAPCs. APC modeling revealed strong age effects and increasing risks in later birth cohorts. Decomposition analysis indicated that changes in age-specific rates were the primary drivers of increases in incidence, prevalence, and DALYs, whereas population aging contributed most substantially to mortality growth. BAPC projections suggest continued increases in ASIR, ASPR, and ASDR through 2040, with more moderate growth in ASMR.
CONCLUSION: The burden of MNBAC in China has increased substantially over the past three decades, characterized by rising incidence and prevalence alongside relatively slower mortality growth. Population aging, cohort-related risk accumulation, and evolving lifestyle and environmental exposures may underlie these trends. Strengthened early intervention and long-term management strategies are needed to mitigate the projected future burden.
METHODS: Data were obtained from the Global Burden of Disease Study 2023. We analyzed incidence, prevalence, deaths, and disability-adjusted life years (DALYs), along with age-standardized rates. Joinpoint regression was used to estimate annual percent change (APC) and average annual percent change (AAPC). Age-period-cohort (APC) models were applied to evaluate age, period, and cohort effects. A decomposition analysis quantified the contributions of population growth, population aging, and changes in age-specific rates. Bayesian age-period-cohort (BAPC) models were used to project trends through 2040.
RESULTS: From 1990 to 2023, incident cases, prevalent cases, and deaths increased approximately threefold, while DALYs increased by 1.8-fold. The age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) increased by 125.71% and 134.62%, with AAPCs of 2.63% and 2.78%, respectively. In contrast, the age-standardized DALYs rate (ASDR) and age-standardized mortality rate (ASMR) increased by 59.21% and 69.64%, with comparatively lower AAPCs. APC modeling revealed strong age effects and increasing risks in later birth cohorts. Decomposition analysis indicated that changes in age-specific rates were the primary drivers of increases in incidence, prevalence, and DALYs, whereas population aging contributed most substantially to mortality growth. BAPC projections suggest continued increases in ASIR, ASPR, and ASDR through 2040, with more moderate growth in ASMR.
CONCLUSION: The burden of MNBAC in China has increased substantially over the past three decades, characterized by rising incidence and prevalence alongside relatively slower mortality growth. Population aging, cohort-related risk accumulation, and evolving lifestyle and environmental exposures may underlie these trends. Strengthened early intervention and long-term management strategies are needed to mitigate the projected future burden.