What are the incidence and prevalence statistics for primary (non‑metastatic) bone cancer?

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Last updated: October 5, 2026 • View editorial policy

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Primary Bone Cancer Statistics

Primary bone cancers are extremely rare, accounting for less than 0.2% of all malignant tumors, with an overall incidence of approximately 0.8-0.9 cases per 100,000 people per year. 1

Overall Incidence Rates

The incidence of primary (non-metastatic) bone cancer varies significantly by tumor type, with no single subtype exceeding 0.3 cases per 100,000 per year 1. The most recent U.S. data estimates approximately 3,010 new cases diagnosed annually 2, with a mortality rate of 4.41 per million people per year 3.

Incidence by Tumor Type

Osteosarcoma

  • Most common primary bone cancer with an incidence of 0.2-0.3 per 100,000 per year in the general population 1
  • Dramatically higher in adolescents: 0.8-1.1 per 100,000 per year at ages 15-19, where it accounts for more than 10% of all solid cancers 1
  • Male to female ratio: 1.4:1 1
  • Represents approximately 35% of all primary bone cancers 2
  • Bimodal age distribution: first peak during adolescence (coinciding with pubertal growth spurt), second peak in adults over 65 years (often associated with Paget's disease) 4

Chondrosarcoma

  • Most frequent bone sarcoma in adults with an incidence of approximately 0.2 per 100,000 per year 1
  • Median age at diagnosis: 30-60 years 1
  • Male to female ratio: approximately 1:1 1
  • Represents approximately 30% of all primary bone cancers 2

Ewing Sarcoma

  • Third most common primary bone malignancy with an incidence of 0.3 per 100,000 per year in white Caucasians under age 25 1
  • Median age at diagnosis: 15 years 1
  • Male predominance: 1.5:1 1
  • Represents approximately 16% of all primary bone cancers 2
  • Striking ethnic differences: very uncommon in African and Asian populations 1

Chordoma

  • Extremely rare with an incidence of approximately 0.5 per million population per year 1
  • Represents 1-5% of all primary malignant bone tumors 2

Racial and Ethnic Disparities

Black patients have the highest incidence of osteosarcoma at 6.8 per million per year, followed by Hispanics at 6.5 per million, and Caucasians at 4.6 per million 4. This disparity has been linked to genetic risk factors, with recent studies identifying germline variants that increase susceptibility 1. The incidence in Black patients has shown a significant increasing trend over recent decades 5.

Temporal Trends

Recent population-based analyses reveal evolving patterns:

  • Chordoma incidence has increased significantly (3.0% per year) 3
  • Overall mortality rates show a slight upward trend (0.7% per year from 2000-2017), driven primarily by increases in osteosarcoma mortality among females and white patients 3
  • Incidence has increased in patients aged 60-79 years and in tumors ≥8 cm 3
  • The limited-duration prevalence increased dramatically from 0.00069% in 2000 to 0.00749% in 2018 6

Critical Clinical Context

A crucial caveat: In adults over 40 years of age, a destructive bone lesion is far more likely to be metastatic disease or myeloma than primary bone cancer 1. Metastatic bone disease and benign bone tumors both significantly outnumber primary malignant bone tumors 1. This underscores that while primary bone cancers are rare overall, they represent an even smaller fraction of all bone lesions encountered clinically.

Survival Outcomes

The overall 5-year survival rate for osteosarcoma is 68%, with survival strongly correlated to age (poorest outcomes in older patients), presence of metastases, tumor location, and response to chemotherapy 4. For all malignant bone tumors combined, the 10-year observed survival rate is 58.0% 6.

References

2
Guideline

bone cancer.

Journal of the National Comprehensive Cancer Network : JNCCN, 2013

4
Research

The epidemiology of osteosarcoma.

Cancer treatment and research, 2009

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