Unveiling trends in malignant neoplasms of bone and articular cartilage mortality in the United States (1999–2023): a CDC WONDER perspective

BackgroundMalignant neoplasms of bone and articular cartilage (MNBAC) are rare but highly fatal cancers contributing to global cancer mortality. This study analyzed demographic and regional patterns of MNBAC mortality in the United States from 1999 to 2023 to identify high-risk populations for targeted interventions.MethodsWe extracted mortality data from the CDC WONDER database using ICD-10 codes C40-C41. Crude and age-adjusted mortality rates (AAMRs) per 100,000 population were calculated by gender, census region, race, and urbanization using R software (version 4.4.2). Joinpoint regression was employed to evaluate annual percentage changes (APCs).ResultsFrom 1999 to 2023, MNBAC mortality trends varied across demographic groups. The South showed the highest AAMR (0.60 in 1999, 95% CI: 0.54 to 0.66; 0.68 in 2023, 95% CI: 0.63 to 0.73), while the West demonstrated the steepest increase (AAPC = 1.33, 95% CI: 0.92 to 1.74). Age analysis revealed the most significant crude mortality rate increases among individuals aged ≥75 years (AAPC = 0.90 for 75-84; AAPC = 1.89 for 85+), with accelerated growth after 2012 (APC = 2.52 and 4.34, respectively). Among racial groups, Hispanics showed the fastest AAMR increase (AAPC = 1.01, 95% CI: 0.36 to 1.66), though non-Hispanic whites maintained the highest AAMR (0.68, 95% CI: 0.64 to 0.72). Metropolitan areas exhibited greater AAMR increases than non-metropolitan areas (AAPC = 0.84 vs. 0.27). Males consistently showed higher AAMRs than females (0.65 vs. 0.45 in 1999; 0.72 vs. 0.53 in 2023; Figure 1). Overall AAMR increased marginally from 2014 to 2018 (APC = 4.26, 95% CI: 0.00 to 8.69) before stabilizing.Figure 1The trend of AAMRs stratified by gender. The * denotes the APC that was found to be statistically at α= 0.05.Line graph showing age-adjusted mortality rates (AAMR) per one hundred thousand population from 1999 to 2023, separated by sex: male (blue), female (green), and both (red). Males consistently have higher rates, females lower, and both combined are intermediate. Shaded regions represent confidence intervals. Key inflection points and annual percent changes (APC) for each group are noted below the graph, indicating periods of increase and decline.ConclusionSignificant disparities exist in MNBAC mortality, with elevated rates among males, Southerners, and non-Hispanic whites. Notable increases occurred in the West, among those aged ≥75 years, Hispanics, and metropolitan residents. These findings underscore the need for targeted interventions to improve outcomes and reduce mortality.