Small-area analyses of bone cancer diagnosed in Great Britain provide clues to aetiology.
BACKGROUND
The aetiology of bone cancers is poorly understood. This study examined geographical patterning in incidence of primary bone cancers diagnosed in 0-49 year olds in Great Britain during 1980-2005 to provide information on factors linked with disease development. We investigated putative associations with deprivation and population density.


METHODS
Data on osteosarcoma and Ewing sarcoma were obtained from national population-based registries. Negative binomial regression was used to examine the relationship between incidence rates and the Townsend deprivation score (and its component variables) and small-area population density.


RESULTS
The study analyzed 2566 osteosarcoma and 1650 Ewing sarcoma cases. For females with osteosarcoma, statistically significant decreased risk was associated with higher levels of deprivation (relative risk [RR] per unit increase in deprivation score = 0.969; 95% confidence interval [CI] 0.946-0.993). For all Ewing sarcoma combined, statistically significant decreased risk was associated with greater area-level population density and higher levels of non-car ownership (RR per person per hectare increase = 0.984; 95% CI 0.976-0.993, RR per 1% increase in non-car ownership = 0.994; 95% CI 0.991-0.998).


CONCLUSIONS
Higher incidence of osteosarcoma was observed for females in areas with lower deprivation levels indicating increased risk is linked to some aspect of affluent living. Higher incidence of Ewing sarcoma occurred in areas of low population density and where more people owned cars, both characteristic of rural environments. The study adds substantially to evidence associating Ewing sarcoma risk with rural environmental exposures. Putative risk factors include agricultural exposures, such as pesticides and zoonotic agents.
Institute of Health and Society, Newcastle University, England, UK. richard.mcnally@ncl.ac.uk
Richard J Q
RJ
McNally
Karen
K
Blakey
Roger C
RC
Parslow
Peter W
PW
James
Basilio Gómez
BG
Pozo
Charles
C
Stiller
Tim J
TJ
Vincent
Paul
P
Norman
Patricia A
PA
McKinney
Michael F
MF
Murphy
Alan W
AW
Craft
Richard G
RG
Feltbower
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001859:Bone Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000453:epidemiology* / Q000209:etiology*; D012512:Sarcoma, Ewing / Q000453:epidemiology / Q000209:etiology; D012737:Sex Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult