Malignant neoplasm of bone and articular cartilage mortality trends in the United States

Malignant neoplasms of bone and articular cartilage (MNBAC) carry a disproportionately high mortality burden. Long-term mortality patterns may inform targeted public health interventions. This study examines MNBAC-related mortality among adults aged 25 years and older from 1999 to 2023. This study analyzed MNBAC-related mortality from 1999 to 2023 using the CDC WONDER Multiple Cause of Death database and International Classification of Diseases, Tenth Revision codes. Age-adjusted mortality rates (AAMRs) per 100,000 population were standardized to the 2000 US population. Trends were assessed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Analyses were stratified by age, sex, race, region, urbanization, and state. There were 33,724 MNBAC-related deaths in the United States from 1999 to 2023. The AAMR was 0.53 per 100,000 population (95% confidence interval [CI]: 0.49 to 0.56) in 1999 and 0.61 (95% CI: 0.58 to 0.64) in 2023, corresponding to a significant AAPC of 0.59% (95% CI: 0.30 to 0.87, P = .001). Joinpoint regression identified 3 segments (1999–2014, APC = −0.22%, P = .282; 2014–2018, APC = 4.26%, P = .087; 2018–2023, APC = 0.15%, P = .969), none of which reached statistical significance; the higher rates after 2014 should be interpreted with caution. Males had higher mortality than females; both sexes showed significant upward trends (AAPC: males 0.56%, P = .020; females 0.76%, P = .004). Non-Hispanic Whites exhibited the highest AAMRs, whereas non-Hispanic Others had the highest AAPC. The South recorded the highest AAMRs, while the West had the highest AAPC. Nonmetropolitan areas maintained higher AAMRs than metropolitan areas from 1999 to 2020, the last year for which urbanization-specific data were available, while a significant upward trend (2013–2020) was observed only in metropolitan areas. California reported the highest death counts. Individuals aged 85 + years had persistently elevated AAMRs over the entire study period. MNBAC-related mortality among US adults increased modestly from 1999 to 2023 and varied across demographic and geographic groups. Because death certificate data contain no information on tumor subtype, stage, treatment, or comorbidity, these findings are descriptive and hypothesis-generating: they identify subgroups carrying a disproportionate mortality burden but cannot determine reasons for these differences.