Epidemiology of primary bone tumors and economical aspects of bone metastases

Primary bone tumors are rare and as such they form a difficult category of tumors for appropriate recognition and classification both for clinicians as well as pathologists. Both benign as well as malignant primary tumors of bone are greatly outnumbered by metastases to the bone from epithelial cancers or melanoma and hematological disorders like multiple myeloma/plasmacytoma. Bone metastasis weighs heavily on the health care budget. The reports available thus far on the economical impact underestimate the total cost, since they only give an estimate of the direct costs, and not the indirect and intangible costs. Available data are difficult to compare due to the difference in costs included-differences in treatment modalities, the period over which the costs are calculated, the method of calculation, and index changes over the years. The financial impact is more substantial for patients with cancer at a younger age and for cancer types with prolonged survival rates even with bony metastasis.