Burden of Malignant Neoplasm of Bone and Articular Cartilage: Trends (1990-2021), Projections to 2030, and Comparison Between China and the G20 Countries (GBD 2021).

Purpose: This study aimed to compare the burden of malignant neoplasm of bone and articular cartilage (MNBAC) between China and the Group of Twenty (G20) countries from 1990 to 2021 and to project trends in China to 2030, thereby informing the development of targeted interventions. Methods: We extracted data on the incidence, prevalence, mortality, disability-adjusted life years (DALYs), and their corresponding age-standardized rates (ASRs) for MNBAC from the Global Burden of Disease (GBD) 2021 study. Trends were assessed based on the magnitude and precision of the estimates, without relying on statistical significance testing. Joinpoint regression identified periods with meaningful trend changes, expressed as the average annual percent change (AAPC). Decomposition analysis was employed to quantify the drivers of changes in incidence, prevalence, mortality, and DALYs. The Bayesian age-period-cohort (BAPC) model was used to project the ASR burden of MNBAC in China up to 2030. Results: From 1990 to 2021, the absolute number of MNBAC cases in China increased substantially. China's relative ranking among G20 countries rose dramatically: its age-standardized incidence rate (ASIR) climbed from 19th to 1st, age-standardized prevalence rate (ASPR) from 20th to 1st, age-standardized mortality rate (ASMR) from 13th to 4th, and age-standardized DALY rate (ASDR) from 16th to 6th. The MNBAC burden was consistently higher in males than females across all G20 countries. Decomposition analysis indicated that population aging and epidemiological changes were the primary drivers of the increasing burden in China, whereas population growth was the dominant factor in the G20 nations overall. Projections from the BAPC model suggest a decline in MNBAC-related ASIR, ASMR, and ASDR in China from 2022 to 2030. Conclusion: Despite a substantial increase in the MNBAC burden in China over the past three decades, our projections indicate a forthcoming decline in the ASIR, ASMR, and ASDR, which is likely attributable to sustained public health efforts. These findings underscore the necessity for continued, targeted interventions, particularly for males and high-risk age groups.