Long term trends and future projections of malignant neoplasm of bone and articular cartilage burden in China

Malignant neoplasm of bone and articular cartilage (MNBAC) is a rare but clinically aggressive group of cancers associated with substantial premature mortality and disability. This study assessed the long-term burden of MNBAC in China from 1990 to 2021 and projected future trends. Estimates of MNBAC incidence, prevalence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) were obtained from the Global Burden of Disease Study 2021. Joinpoint regression was used to quantify temporal trends, and age–period–cohort analysis was conducted to characterize variations by age, calendar period, and birth cohort. Decomposition analysis estimated the contributions of population growth, population aging, and epidemiological change to changes in disease burden. Bayesian age–period–cohort models were used to project age-standardized rates through 2030. In 2021, China had an estimated 25,938 incident MNBAC cases, 166,569 prevalent cases, 18,085 deaths, and 527,284 DALYs. Males consistently experienced higher incidence, prevalence, mortality, DALY, YLD, and YLL rates than females, and the burden was concentrated predominantly among middle-aged and older adults. From 1990 to 2021, the age-standardized incidence, prevalence, mortality, DALY, and YLD rates increased significantly, with average annual percentage changes of 2.59%, 2.71%, 0.44%, 1.26%, and 2.51%, respectively. The age-standardized YLL rate showed no significant overall change. In contrast, global age-standardized mortality and YLL rates declined. Epidemiological change was the largest contributor to increases in incident and prevalent cases, whereas both epidemiological change and population aging contributed substantially to the increase in DALYs. Age-standardized incidence, prevalence, and DALY rates were projected to decline modestly, with more pronounced reductions among females. The absolute burden of MNBAC in China increased substantially from 1990 to 2021, with males and older adults disproportionately affected. Although several age-standardized rates have recently declined and are projected to decrease further, population aging and persistent sex disparities are likely to sustain a considerable healthcare burden.