Table 1.
The risks of suicide and accident death among patients with primary malignant bone tumors diagnosed between 1 January 1973 and 31 December 2017.
| Variable | No. of Patients | Person-years | Suicides† |
Accident deaths† |
||||
|---|---|---|---|---|---|---|---|---|
| No. of deaths | Mortality rate‡ | SMR (95%CI) | No. of deaths | Mortality rate‡ | SMR (95%CI) | |||
| Sex | ||||||||
| Female | 22,039 | 182281.96 | 21 | 11.52 | 2.88 (1.88–4.42) | 82 | 44.99 | 2.64 (2.12–3.27) |
| Male | 28,778 | 214509.54 | 87 | 40.56 | 2.74 (2.22–3.38) | 184 | 85.78 | 2.26 (1.95–2.61) |
| Race | ||||||||
| Black | 4874 | 37689.46 | 3 | 7.96 | 1.80 (0.58–5.57) | 17 | 45.11 | 1.81 (1.13–2.92) |
| White | 41,682 | 326542.33 | 105 | 32.16 | 2.97 (2.45–3.60) | 232 | 71.05 | 2.39 (2.10–2.72) |
| Other | 4261 | 32559.71 | 0 | 0.00 | 0.00 | 17 | 52.21 | 2.75 (1.71–4.42) |
| Year of diagnosis | ||||||||
| 1973–1984 | 5275 | 73548.88 | 29 | 39.43 | 3.07 (2.13–4.42) | 38 | 51.67 | 1.42 (1.03–1.95) |
| 1985–1995 | 7091 | 95095.42 | 18 | 18.93 | 1.84 (1.16–2.91) | 53 | 55.73 | 1.95 (1.49–2.55) |
| 1996–2006 | 17,281 | 153892.67 | 35 | 22.74 | 2.59 (1.86–3.61) | 120 | 77.98 | 3.05 (2.55–3.64) |
| 2007–2017 | 21,170 | 74254.54 | 26 | 35.01 | 4.14 (2.82–6.08) | 55 | 74.07 | 2.87 (2.20–3.74) |
| Income | ||||||||
| High | 18,538 | 151906.83 | 25 | 16.46 | 2.38 (1.61–3.53) | 96 | 63.20 | 3.71 (3.04–4.53) |
| Median | 16,450 | 119125.50 | 34 | 28.54 | 2.98 (2.13–4.17) | 75 | 62.96 | 2.53 (2.01–3.17) |
| Low | 13,269 | 89292.67 | 34 | 38.08 | 2.67 (1.91–3.74) | 73 | 81.75 | 1.77 (1.41–2.23) |
| Unknown | 2560 | 36466.50 | 15 | 41.13 | 3.38 (2.04–5.61) | 22 | 60.33 | 1.39 (0.92–2.12) |
| Education | ||||||||
| High | 10,241 | 59888.38 | 18 | 30.06 | 2.16 (1.36–3.44) | 58 | 96.85 | 2.03 (1.57–2.63) |
| Median | 11,361 | 92900.33 | 24 | 25.83 | 1.95 (1.31–2.91) | 42 | 45.21 | 1.22 (0.90–1.65) |
| Low | 11,627 | 103928.04 | 29 | 27.90 | 2.07 (1.44–2.98) | 74 | 71.20 | 2.19 (1.74–2.74) |
| Unknown | 17,588 | 140074.75 | 37 | 26.41 | 8.34 (6.04–11.51) | 92 | 65.68 | 5.83 (4.75–7.15) |
| Stage | ||||||||
| Localized | 18,189 | 181461.88 | 48 | 26.45 | 2.60 (1.96–3.45) | 124 | 68.33 | 2.40 (2.01–2.86) |
| Regional | 17,340 | 144462.67 | 47 | 32.53 | 3.35 (2.51–4.45) | 94 | 65.07 | 2.30 (1.88–2.81) |
| Distant | 8628 | 31543.33 | 4 | 12.68 | 1.47 (0.55–3.92) | 18 | 57.06 | 2.21 (1.39–3.51) |
| Unknown | 6660 | 39323.63 | 9 | 22.89 | 2.37 (1.23–4.55) | 30 | 76.29 | 2.53 (1.77–3.61) |
| Site§ | ||||||||
| Lower limb | 20,774 | 184135.63 | 55 | 29.87 | 3.46 (2.65–4.50) | 101 | 54.85 | 2.18 (1.80–2.65) |
| Upper limb | 6409 | 55450.29 | 16 | 28.85 | 2.95 (1.81–4.82) | 26 | 46.89 | 1.67 (1.14–2.45) |
| Pelvis | 7930 | 45587.33 | 15 | 32.90 | 2.74 (1.65–4.55) | 39 | 85.55 | 2.54 (1.86–3.48) |
| Skull and Face | 6910 | 52090.17 | 13 | 24.96 | 2.34 (1.36–4.04) | 58 | 111.35 | 3.57 (2.76–4.62) |
| Thorax | 3736 | 30705.58 | 6 | 19.54 | 1.67 (0.75–3.72) | 6 | 19.54 | 0.59 (0.26–1.31) |
| Vertebral column | 3507 | 22272.33 | 3 | 13.47 | 1.21 (0.39–3.76) | 33 | 148.17 | 4.83 (3.43–6.79) |
| Others | 1551 | 6550.17 | 0 | 0.00 | 0.00 | 3 | 45.80 | 1.40 (0.45–4.35) |
| Type¶ | ||||||||
| Osteosarcoma | 17,155 | 133144.29 | 46 | 34.55 | 4.61 (3.45–6.15) | 76 | 57.08 | 2.53 (2.02–3.17) |
| Chondrosarcoma | 13,895 | 126683.83 | 39 | 30.79 | 2.41 (1.76–3.29) | 69 | 54.47 | 1.56 (1.23–1.98) |
| Ewing sarcoma | 7294 | 53812.63 | 10 | 18.58 | 3.04 (1.63–5.65) | 25 | 46.46 | 2.49 (1.68–3.68) |
| Chordoma | 3982 | 26073.29 | 3 | 11.51 | 0.86 (0.28–2.68) | 38 | 145.74 | 3.96 (2.88–5.45) |
| Others | 8491 | 57077.46 | 10 | 17.52 | 1.64 (0.88–3.06) | 58 | 101.62 | 3.09 (2.39–3.99) |
| Surgery | ||||||||
| Yes | 38,116 | 329260.58 | 85 | 25.82 | 2.57 (2.08–3.18) | 207 | 62.86814 | 2.23 (1.94–2.55) |
| None | 10,108 | 46175.50 | 10 | 21.66 | 2.61 (1.41–4.86) | 47 | 101.79 | 3.71 (2.79–4.94) |
| Unknown | 2593 | 21355.42 | 13 | 60.87 | 6.11 (3.55–10.53) | 12 | 56.19 | 1.70 (0.97–3.00) |
| All | 50,817 | 396791.50 | 108 | 27.22 | 2.77 (2.29–3.34) | 266 | 67.04 | 2.36 (2.09–2.66) |
Abbreviations: SMR, standardized mortality ratio; CI, confidence intervals.
In this study, we included all patients with primary malignant bone tumors reported to the eighteen SEER registries (Alaska Native Tumor registry, Connecticut, Detroit, Atlanta, Greater Georgia, Rural Georgia, San Francisco–Oakland, San Jose-Monterey, Greater California, Kentucky, Los Angeles, Louisiana, Hawaii, Iowa, New Mexico, New Jersey, Seattle–Puget Sound, and Utah) diagnosed between January 1, 1973, and December 31, 2017. The data contributed by Idaho, Massachusetts and New York from January 1, 2000, and December 31, 2017 were also available.
Suicide: International Classification of Diseases, Eighth Revision codes 950–959; International Classification of Diseases, Ninth Revision codes 950–959; and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes U03, X60-X84 and Y87.0. Accident death: International Classification of Diseases, Eighth Revision codes 800–949; International Classification of Diseases, Ninth Revision codes 800–949; and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes V01-X59 and Y85-Y86.
Per 100,000 person-years.
Specific primary site code (the International Statistical Classification of Diseases and Related Health Problems, the tenth revision [ICD-10 codes]): skull and face: C41.0, C41.1; thorax: C41.3; vertebral column: C41.2; pelvis: C41.4; upper limb: C40.0, C40.1; lower limb: C40.2, C40.3; others: C40.8, C40.9, C41.8, C41.9.
The histological codes (International Classification of Diseases for Oncology, 3rd Edition [ICD-O-3]): Osteosarcoma: 9180/3–9200/3; Chondrosarcoma: 9220/3–9243/3; Ewing sarcoma: 9260/3; Chordoma: 9370/3–9372/3; Others: 8000/3–9150/3, 9250/3–9251/3, 9261/3–9365/3 and 9380/3–9580/3.