The rise of metastatic bone disease in Ireland
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RESEARCH PAPER
The rise of metastatic bone disease in Ireland Fergus J. McCabe1 · Dima Y. Jadaan2 · Mutaz M. Jadaan1 · John P. McCabe1 Received: 3 July 2020 / Accepted: 14 October 2020 © Springer Nature B.V. 2020
Abstract To describe the expected rise of metastatic bone disease in Ireland, the relative primary types, and the locations of spread within the skeleton. This was a population-based epidemiological study using cancer registry data. We included patients with known metastatic cancer to bone, within 1 year of the primary diagnosis, during the years 1994 to 2012 inclusive. Our main outcome measures were age-specific, gender-specific and age-standardised incidence rates of bone metastasis, primary types and metastatic location within the skeleton. There were 14,495 recognised cases of bone metastasis in Ireland, 1994–2012 inclusive. Cases consistently rose over the time period, with 108% case increase and 51% age-standardised incidence rise. Annual percentage change increased across both genders and over all age groups. Most of this rise was not due to demographic population change. Breast, prostate and lung accounted for the majority of primary types. GI cancers were the fourth most common primary type. There were proportional increases in breast and lung, with proportional decreases in prostate. The spine was the major metastatic site. Bone metastasis is a significant and rising healthcare concern in Ireland. This rise is disproportionate to demographic changes. Breast, prostate and lung cancers account for the majority. GI cancers are implicated in an unexpectedly high number of cases. Spine is the most common location of bony metastasis, especially at presentation. Prudent healthcare planning is necessitated to prepare for the growing consequences of bone metastasis in cancer patients. Keywords Metastatic bone disease · Cancer · Epidemiology · Secondary bone cancer · Neoplasm metastasis
Introduction After the lung and liver, bone is the third most common site of distant metastasis [1]. Indeed, it is the most common site of spread of the most frequent solid cancers: breast and prostate [2, 3]. Metastatic bone disease is an important phenomenon with serious consequences, namely pain, pathological fracture and disability [4, 5]. Spinal involvement can produce metastatic spinal cord compression (MSCC), a surgical emergency [5, 6]. Ireland has the third highest incidence of cancer in the world, with an age-standardized rate of 373.7 per 100,000 person—years [7]. Incidence of cancer in Ireland rose from 1994 to 2010, with 1.3% annual percentage rise in males and 1.2% in females [8]. Since 2010, incidence has remained * Fergus J. McCabe [email protected] 1
Spine Service, Department of Trauma and Orthopaedics, Galway University Hospitals, Galway, Ireland
University College Dublin, Dublin, Ireland
2
stable in women, while average male incidence has fallen by 1.8% [8]. Age-standardised incidence of cancer is expected to continue to fall in both genders [8]. Despite this, overall cases of cancer
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