Bassin et al., in a 2006 study, linked water fluoridation to osteosarcoma. Bassin found a statistically significant relationship between fluoride exposure during the 6th to 8th years of life (the “mid-childhood growth spurt”) and the later development of osteosarcoma among young males. There has been no refutation of Bassin’s study, albeit Kim, Douglass, et al. have made attempts, but failed to do so. (EC)
Researchers have identified differences in osteosarcoma incidence and survival across age groups and racial/ethnic groups, according to a study published in Cancer.
The incidence of osteosarcoma was highest among Black individuals and patients ages 10 to 24 years. Survival rates were relatively stable over the period studied, but survival was worst in males, American Indian/Alaska Native individuals, and older patients.
The researchers analyzed 5016 osteosarcoma cases from the Surveillance, Epidemiology, and End Results program, calculating incidence rates (IRs) and 5-year relative survival (RS) from 1975 to 2017.
For children ages 0 to 9 years, the age-adjusted IR was 1.9 per million. The IR increased over the study period (P <.05) and was highest in the most recent decade (2.3 per million). The IR and RS for this age group were similar between the sexes. The 5-year RS was 71.8% and increased steadily over the study period.
For patients ages 10 to 24 years, the IR was 7.2 per million. The IR increased over the study period (P <.05) and was highest in the most recent decade (6.7 per million). The incidence was highest in Black and Hispanic patients. In addition, osteosarcoma occurred more frequently in males than females in this age group (IR, 8.1 and 6.2 per million, respectively). The 5-year RS rate was 65.9% overall and in the most recent decade.
For patients ages 25 to 59 years, the IR was 1.9 per million. The incidence was relatively unchanged throughout the study period (P >.05). The 5-year RS was 56.8% overall and 57.7% in the most recent decade.
For patients older than 60 years, the IR was 3.5 per million. The IR was 2 per million in the most recent decade and decreased throughout the study period (P <.05). The 5-year RS was 33.1% overall and 38.0% in the most recent decade, which was a significant increase from the RS in the 2000s (P =.008)
Metastatic disease was more common in the oldest age group, and these patients had the highest incidence of subsequent osteosarcoma.
Black individuals had the highest incidence of osteosarcoma across all age groups and a significant increase in incidence throughout the study period (P <.05). Five-year RS rates were similar across most races/ethnicities, but American Indian/Alaska Native patients had the lowest RS (36.9%).
“The epidemiologic differences we identified in these groups may reflect differences in the underlying biology and/or genetic susceptibility,” the researchers wrote.
They added that further studies are needed to better understand osteosarcoma etiology across all ages and racial/ethnic groups to improve risk stratification, targeted treatment, and patient outcomes.
Cole S, Gianferante DM, Zhu B, Mirabello L. Osteosarcoma: A Surveillance, Epidemiology, and End Results program-based analysis from 1975 to 2017. Cancer. Published online February 28, 2022. doi:10.1002/cncr.34163