Thorkildsen Joachim, Myklebust Tor Åge
Division of Orthopaedic Surgery, Oslo University Hospital, Nydalen, Oslo, Norway.
Department of Registration, Cancer Registry of Norway, Majorstuen, Oslo, Norway.
Acta Oncol. 2023 Feb;62(2):110-117. doi: 10.1080/0284186X.2023.2177975. Epub 2023 Mar 1.
Chondrosarcoma (CS) epidemiology has been studied by a number of authors using national cancer registry cohorts. Many reports share the common findings of a slight increase in incidence, but not all. The patterns and causes for these changes are divergent while reflection concerning methodological challenges are often missing.
We have performed a structured literature review to find national analyses of CS incidence published from 2010 to 2020. We included eight studies of national incidence of CS, summarise their findings and patterns of change. We further discuss explanations given for these changes to better understand the real patterns and raise awareness in their interpretation.
Reported crude incidence ranges from 0.27 per million per year overall in Saudi Arabia to 5.4 in the Netherlands. Four studies from the USA, England, Switzerland and France report age standardised rates of 2.0-4.1 per million per year overall. While some countries report stable patterns, most report a slight increase. The Netherlands is the only country reporting a large increase, driven by a 10-fold increase in the incidence of ACT/grade 1 CS during the study period. We challenge the explanations given for this and suggest that this most likely is a result of variable interpretation and definition of CS at the lower levels of disease aggressiveness. This should raise awareness to possible over-treatment of CS in the Netherlands.
The most likely national incidence of CS of bone is between 2-4 per million per year. Three modern reports present an incidence of 3.4-4.1 per million per year.
许多作者利用国家癌症登记队列研究了软骨肉瘤(CS)的流行病学。许多报告都有发病率略有上升的共同发现,但并非所有报告都是如此。这些变化的模式和原因各不相同,同时往往缺少对方法学挑战的反思。
我们进行了一项结构化文献综述,以查找2010年至2020年发表的关于CS发病率的全国性分析。我们纳入了八项关于CS全国发病率的研究,总结了它们的发现和变化模式。我们进一步讨论了对这些变化的解释,以更好地理解实际模式,并提高对其解读的认识。
报告的粗发病率范围从沙特阿拉伯每年每百万人口0.27例到荷兰的5.4例。来自美国、英国、瑞士和法国的四项研究报告总体年龄标准化发病率为每年每百万人口2.0 - 4.1例。虽然一些国家报告发病率模式稳定,但大多数国家报告略有上升。荷兰是唯一一个报告大幅上升的国家,这是由研究期间ACT/1级CS发病率增加10倍所驱动的。我们对对此给出的解释提出质疑,并认为这很可能是由于在疾病侵袭性较低水平时对CS的解释和定义存在差异所致。这应该提高人们对荷兰可能存在的CS过度治疗的认识。
骨CS最可能的全国发病率为每年每百万人口2 - 4例。三项现代报告显示发病率为每年每百万人口3.4 - 4.1例。