Cancers of the musculoskeletal system affect both children and adults, but virtually all tumors have different age-based frequency. Myeloma, the cancer of the bone marrow, affects older persons more, while other bone and joint tumors are more prevalent in children and young adults. Soft tissue sarcomas affect all ages, but most are more common as persons reach middle age and later years. See individual cancer discussions for further information.
Certain primary cancers of bones and joints (osteosarcoma and Ewing sarcoma) are found among those under the age of 30 years in higher proportion than expected for the overall incidence of most sarcomas. In 2006–2010, 43% of bone and joint cancers diagnosed were found in people under the age of 35 years, with more than 27% occurring among children and adolescents under the age of 20. This compares to less than 4% of all cancer sites in people aged 35 years and younger, and only 1% in those younger than 20 years. Hodgkin lymphoma is the only other cancer to affect young people in similar numbers, with a higher percentage of cases diagnosed in the 20-year to 34-year age range. The average age at diagnosis for bone and joint cancers is 42 years, surpassed in youthfulness only by Hodgkin lymphoma, diagnosed at an average age of 38 years. (Reference Table 8A.2.1 PDF [1] CSV [2] and Table 8A.3.2 PDF [3] CSV [4])
Deaths from bone and joint cancer also are more common in people under the age of 35 years. Between 2006 and 2010, 13% of deaths from bone and joint cancer occurred in children and youth under the age of 20, and an additional 15% among young adults aged 20 years to 34 years. The mortality rate among younger persons from bone and joint cancer comprises only 0.2% of deaths from all types of cancer, but is 8% of cancer deaths in people under the age of 20 years and 5% of deaths among young people aged 20 to 34 years. The relative proportion of deaths from bones and joints cancer was higher in children, youth, and young adults than all other cancer types that disproportionately affect younger people, including brain and nervous system, leukemia, endocrine system, and soft tissue cancers. The average age at death for bone and joint cancer is 59 years, the youngest of all types of cancer. (Reference Table 8A.2.2 PDF [5] CSV [6] and Table 8A.3.4 PDF [7] CSV [8])
In 2010, osteosarcoma accounted for 54% of the malignant bone tumors in survivors diagnosed with cancer as children and alive on January 1, 2010. The majority of the remaining bone tumors in survivors diagnosed as children and still alive had been diagnosed with Ewing sarcoma (29%). Among the childhood cancer survivors of all ages, 4% were survivors of bone tumors, a proportion that increased slightly with age. Males were a greater proportion of the osteosarcoma survivors than were females until survivors reached middle age, when females were a larger share. Nearly one in four (22%) of the survivors had been diagnosed some 35 years ago. This is comparable with childhood cancer survivors for all types of cancer, where 20% were diagnosed more than 35 years before death. (Reference Table 8A.6.1 PDF [9] CSV [10] and Table 8A.6.2 PDF [11] CSV [12])
Although not considered a childhood cancer, soft tissue sarcomas, which affect all ages, accounted for 9% of new diagnoses in the years 2006 to 2010 in children and young adults under the age of 20. Another 9% were found in the population age 20 to 34. Deaths from soft tissue sarcomas in this time frame were slightly lower, but still accounted for a higher proportion of cancer deaths in the under 35 population (4% and 6%, respectively) than all except bone and joint cancers. (Reference Table 8A.3.2 PDF [3] CSV [4] and Table 8A.3.4 PDF [7] CSV [8])
Rhabdomyosarcoma, a soft tissue sarcoma, accounts for 3% of all new childhood cancers each year. The 5-year survival rate when detected in children under the age of 14 is 64%.1
The high incidence and mortality rate of bone cancers among children, youth, and young adults creates a significant burden on the productivity and life of future generations. Apart from the financial costs, emotional toil, and lost lives from the initial treatments, survivors carry significant functional burdens and continuing care costs. At least 75% of surviving bone and joint cancer patients are treated with limb-salvaging surgery. These surgeries most often require implantation of massive bone-replacing endoprostheses that have limited life span and compromised function, requiring periodic surveillance and revision surgery to repair or replace worn parts. The amputated survivors will require prosthetic limbs, the function of which is clearly limiting in comparison to normal activity. Both procedures are expensive. The cost estimate nearly ten years ago was $25,000 per year for artificial limb replacement of an amputated limb in an active 20- to 30-year- old man in 1997 dollars. The cost estimate was $23,500 for implant, rehabilitation, monitoring, and replacement with limb salvaging endoprostheses.1 More recent cost estimates are not available. Due to chronic pain and overall dysfunction, a large number of such survivors will end up on disability, requiring public support for the majority of their adult lifetime.
More than 60% of myeloma cases are diagnosed in persons age 65 years and older. This is a similar rate to respiratory and urinary system cancers, both of which disproportionately affect older persons. Soft tissue cancers affect all ages, and in relatively equal proportion in the middle years (ages 35 to 64 years) and older population (65 years and older). As previously discussed, bone and joint cancers affect a disproportionate number of younger persons, and are not considered a major cancer of aging. (Reference Table 8A.3.2 PDF [3] CSV [4])
Because of the advanced age of many myeloma patients, and the average survival rate of 6 years following diagnosis coupled with a less than 50% 5-year survival rate, 76% of deaths from myeloma occur to the 65 and older population. Soft tissue cancer deaths occur about equally in people under 65 years and those 65 years and older. Deaths from bone and joint cancers have a lower rate in the 65-year and older population than nearly all other cancers, primarily due to the higher rate of death in those under 35 years of age.(Reference Table 8A.3.4 PDF [7] CSV [8])
The average age of the population in the United States continues to rise. With age, the human body’s ability to cope with stress and illness declines. As a result, poorer outcomes from cancers are expected in the aged due to greater decline in functional status, adaptability and an increase in co-morbid conditions, all of which have been shown to have an effect on survival.
Links:
[1] https://www.boneandjointburden.org/docs/T8A.2.1.pdf
[2] https://www.boneandjointburden.org/docs/T8A.2.1.csv
[3] https://www.boneandjointburden.org/docs/T8A.3.2.pdf
[4] https://www.boneandjointburden.org/docs/T8A.3.2.csv
[5] https://www.boneandjointburden.org/docs/T8A.2.2.pdf
[6] https://www.boneandjointburden.org/docs/T8A.2.2.csv
[7] https://www.boneandjointburden.org/docs/T8A.3.4.pdf
[8] https://www.boneandjointburden.org/docs/T8A.3.4.csv
[9] https://www.boneandjointburden.org/docs/T8A.6.1.pdf
[10] https://www.boneandjointburden.org/docs/T8A.6.1.csv
[11] https://www.boneandjointburden.org/docs/T8A.6.2.pdf
[12] https://www.boneandjointburden.org/docs/T8A.6.2.csv
[13] http://www.cancer.net/cancer-types/rhabdomyosarcoma-childhood/statistics