A relief or new challenges? Global, regional, and national burden of malignant neoplasm of bone and articular cartilage in children and adolescents from 1990 to 2021 and its prediction to 2035

Malignant neoplasm of bone and articular cartilage (MNBAC) represents an increasing public health concern among children and adolescents, yet comprehensive data on its prevalence, incidence, mortality, and disability-adjusted life years (DALYs) remain limited. This study analyzes global, regional, and national trends in MNBAC burden over the past three decades. Data from the Global Burden of Disease (GBD) 2021 database for the period 1990–2021 were used to assess MNBAC prevalence, incidence, mortality, and DALYs. The analysis included numbers, rates, age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized DALYs rate (ASDR), and average annual percentage changes (AAPCs). Trends were examined by age, sex, region, and socio-demographic index (SDI) using jointpoint analysis and predictive modeling. Globally, the incidence and prevalence of MNBAC in children and adolescents have shown a significant upward trend. In 2021, the global incidence was 19,679 (16,490–23,501), with 8,573 (7,257–10,618) deaths. Age-standardized incidence and prevalence rates continued to rise, with AAPCs of 0.45 (0.43 to 0.46) and 0.46 (0.44 to 0.47). Both the ASMR and ASDR initially increased and then decreased over the 30-year period, with the most significant turning point occurring in 2005. Incidence and mortality rates generally increased with age, peaking in the 15–19 age group, and were higher in males than females. In 2021, India had the highest number of incidence cases and deaths, whereas Tokelau reported the highest ASIR, ASPR, ASMR, and ASDR. The region with the highest ASIR, ASPR, ASMR, and ASDR was Eastern Sub-Saharan Africa. ASMR and ASDR decreased as SDI levels increased. Projection analysis suggests a continued decline in incidence, prevalence, deaths, and DALYs from 2022 to 2035. The incidence and prevalence of MNBAC in children and adolescents have increased over the past three decades. Although deaths and DALYs have decreased since 2005, health inequalities persist, potentially increasing the overall disease burden. Encouragingly, projections suggest a continuing downward trend in the future, but significant disparities remain across regions, countries, genders, ages, and SDI levels. Addressing these disparities requires targeted interventions that consider the factors driving these differences, aiming to reduce the burden of MNBAC in children and adolescents.