Skip to main content

Advertisement

Log in

The rise of metastatic bone disease in Ireland

  • Research Paper
  • Published:
Clinical & Experimental Metastasis Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Clines GA, Guise TA (2008) Molecular mechanisms and treatment of bone metastasis. Expert Rev Mol Med 10:e7

    Article  Google Scholar 

  2. Gandaglia G, Abdollah F, Schiffmann J, Trudeau V, Shariat SF, Kim SP, Perrotte P, Montorsi F, Briganti A, Trinh QD, Karakiewicz PI, Sun M (2014) Distribution of metastatic sites in patients with prostate cancer: a population-based analysis. Prostate 74:210–216

    Article  Google Scholar 

  3. Kennecke H, Yerushalmi R, Woods R, Cheang MC, Voduc D, Speers CH, Nielsen TO, Gelmon K (2010) Metastatic behavior of breast cancer subtypes. J Clin Oncol 28:3271–3277

    Article  Google Scholar 

  4. Coleman RE (2001) Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 27:165–176

    Article  CAS  Google Scholar 

  5. Harel R, Angelov L (2010) Spine metastases: current treatments and future directions. Eur J Cancer 46:2696–2707

    Article  Google Scholar 

  6. Baek YH, Jeon HL, Oh IS, Yang H, Park J, Shin JY (2019) Incidence of skeletal-related events in patients with breast or prostate cancer-induced bone metastasis or multiple myeloma: a 12-year longitudinal nationwide healthcare database study. Cancer Epidemiol 61:104–110

    Article  Google Scholar 

  7. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424

    Article  Google Scholar 

  8. National Cancer Registry (2019a) Cancer incidence projections for Ireland 2020–2045. National Cancer Registry, Cork

    Google Scholar 

  9. Central Statistics Office (2020) Vital Statistics Yearly Summary 2019.

  10. Marasigan V, Perry I, Bennett K, Balanda K, Capewell S, O’ Flaherty M, Kabir Z, (2020) Explaining the fall in Coronary Heart Disease mortality in the Republic of Ireland between 2000 and 2015 - IMPACT modelling study. Int J Cardiol 310:159–161

    Article  Google Scholar 

  11. National Cancer Registry (2019b) Cancer in Ireland 1994–2017 with estimates for 2017–2019: Annual report of the National Cancer Registry. National Cancer Registry, Cork

    Google Scholar 

  12. National Cancer Registry (2012) Completeness at the Irish National Cancer Registry. National Cancer Registry, Cork

    Google Scholar 

  13. Cetin K, Christiansen CF, Sværke C, Jacobsen JB, Sørensen HT (2015) Survival in patients with breast cancer with bone metastasis: a Danish population-based cohort study on the prognostic impact of initial stage of disease at breast cancer diagnosis and length of the bone metastasis-free interval. BMJ Open 5:e007702

    Article  Google Scholar 

  14. Nørgaard M, Jensen AØ, Jacobsen JB, Cetin K, Fryzek JP, Sørensen HT (2010) Skeletal related events, bone metastasis and survival of prostate cancer: a population based cohort study in Denmark (1999 to 2007). J Urol 184:162–167

    Article  Google Scholar 

  15. Svensson E, Christiansen CF, Ulrichsen SP, Rørth MR, Sørensen HT (2017) Survival after bone metastasis by primary cancer type: a Danish population-based cohort study. BMJ Open 7:e016022

    Article  Google Scholar 

  16. Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Nikšić M, Bonaventure A, Valkov M, Johnson CJ, Estève J (2018) Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet 391:1023–1075

    Article  Google Scholar 

  17. Yang H-L, Liu T, Wang X-M, Xu Y, Deng S-M (2011) Diagnosis of bone metastases: a meta-analysis comparing 18 FDG PET, CT, MRI and bone scintigraphy. Eur Radiol 21:2604–2617

    Article  Google Scholar 

  18. Piccioli A, Maccauro G, Spinelli MS, Biagini R, Rossi B (2015) Bone metastases of unknown origin: epidemiology and principles of management. J Orthop Traumatol 16:81–86

    Article  Google Scholar 

  19. Riihimäki M, Hemminki A, Fallah M, Thomsen H, Sundquist K, Sundquist J, Hemminki K (2014) Metastatic sites and survival in lung cancer. Lung Cancer 86:78–84

    Article  Google Scholar 

  20. National Cancer Registry (2020) Incidence Statistics. https://www.ncri.ie/data/incidence-statistics (accessed 30th April 2020)

  21. Malone PO, P (2020) Trends in Smoking Prevalence and Tobacco Consumption. https://publicpolicy.ie/papers/trends-in-smoking-prevalence-and-tobacco-consumption/ (accessed 30th April 2020)

  22. Lipfert FW, Wyzga RE (2019) Longitudinal relationships between lung cancer mortality rates, smoking, and ambient air quality: a comprehensive review and analysis. Crit Rev Toxicol 49:790–818

    Article  CAS  Google Scholar 

  23. Coleman RE (2006) Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res 12:6243s–6249s

    Article  Google Scholar 

  24. Parameswaran R, Shulin HuJ, Min En N, Tan WB, Yuan NK (2017) Patterns of metastasis in follicular thyroid carcinoma and the difference between early and delayed presentation. Ann R Coll Surg Engl 99:151–154

    Article  CAS  Google Scholar 

  25. Krishnamurthy GT, Tubis M, Hiss J, Blahd WH (1977) Distribution pattern of metastatic bone disease. A need for total body skeletal image. JAMA 237:2504–2506

    Article  CAS  Google Scholar 

  26. Tubiana-Hulin M (1991) Incidence, prevalence and distribution of bone metastases. Bone 12(Suppl 1):S9-10

    Article  Google Scholar 

  27. Organization WH (2004) ICD-10: international statistical classification of diseases and related health problems: tenth revision.

  28. Sciubba DM, Gokaslan ZL, Suk I, Suki D, Maldaun MVC, McCutcheon IE, Nader R, Theriault R, Rhines LD, Shehadi JA (2007) Positive and negative prognostic variables for patients undergoing spine surgery for metastatic breast disease. Eur Spine J 16:1659–1667

    Article  Google Scholar 

  29. Pereira J, Body JJ, Gunther O, Sleeboom H, Hechmati G, Maniadakis N, Terpos E, Acklin YP, Finek J, von Moos R (2016) Cost of skeletal complications from bone metastases in six European countries. J Med Econ 19:611–618

    Article  CAS  Google Scholar 

  30. Tipsmark LS, Bünger CE, Wang M, Morgen SS, Dahl B, Søgaard R (2015) Healthcare costs attributable to the treatment of patients with spinal metastases: a cohort study with up to 8 years follow-up. BMC Cancer 15:354

    Article  Google Scholar 

  31. Robine J-M, Saito Y, Jagger C (2009) The relationship between longevity and healthy life expectancy. Qual Ageing Older Adults 10:5

    Article  Google Scholar 

  32. Barzilai O, Boriani S, Fisher CG, Sahgal A, Verlaan JJ, Gokaslan ZL, Lazary A, Bettegowda C, Rhines LD, Laufer I (2019) Essential concepts for the management of metastatic spine disease: what the surgeon should know and practice. Glob Spine J 9:98S-107S

    Article  Google Scholar 

  33. Wouterse B, Huisman M, Meijboom BR, Deeg DJH, Polder JJ (2015) The effect of trends in health and longevity on health services use by older adults. BMC Health Serv Res 15:574

    Article  Google Scholar 

  34. Johnson CN, Gurich RW, Pavey GJ, Thompson MJ (2019) Contemporary management of appendicular skeletal metastasis by primary tumor type. J Am Acad Orthop Surg 27:345–355

    Article  Google Scholar 

  35. Yahanda AT, Buchowski JM, Wegner AM (2019) Treatment, complications, and outcomes of metastatic disease of the spine: from Patchell to PROMIS. Ann Transl Med 7:216

    Article  Google Scholar 

  36. Turpin A, Duterque-Coquillaud M, Vieillard MH (2020) Bone metastasis: current state of play. Transl Oncol 13:308–320

    Article  Google Scholar 

  37. Zheng X-Q, Huang J-F, Lin J-L, Chen L, Zhou T-T, Chen D, Lin D-D, Shen J-F, Wu A-M (2019) Incidence, prognostic factors, and a nomogram of lung cancer with bone metastasis at initial diagnosis: a population-based study. Transl Lung Cancer Res 8:367

    Article  Google Scholar 

  38. D’Oronzo S, Coleman R, Brown J, Silvestris F (2019) Metastatic bone disease: Pathogenesis and therapeutic options: up-date on bone metastasis management. J Bone Oncol 15:004–004

    PubMed  Google Scholar 

  39. Curtin M, Piggott RP, Murphy EP, Munigangaiah S, Baker JF, McCabe JP, Devitt A (2017) Spinal metastatic disease: a review of the role of the multidisciplinary team. Orthop Surg 9:145–151

    Article  Google Scholar 

  40. Murphy CC, Yang YC (2018) Use of age-period-cohort analysis in cancer epidemiology research. Curr Epidemiol Rep 5:418–431

    Article  Google Scholar 

Download references

Acknowledgements

Dr Sandra Deady: National Cancer Registry of Ireland

Funding

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fergus J. McCabe.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

Ethical approval was not required as data used for analysis was anonymised data collected by the statutory cancer registry of Ireland.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McCabe, F.J., Jadaan, D.Y., Jadaan, M.M. et al. The rise of metastatic bone disease in Ireland. Clin Exp Metastasis 37, 693–702 (2020). https://doi.org/10.1007/s10585-020-10059-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10585-020-10059-7

Keywords

Navigation