Epidemiology of bone cancer in Saudi Arabia: a nationwide population-based study (2004–2020)

Background Bone cancer is a rare malignancy worldwide, with incidence patterns that vary by age, sex, and geographic region. In Saudi Arabia, however, comprehensive population-based evidence describing the national epidemiology of bone cancer remains limited. This study aimed to describe bone cancer incidence in Saudi Arabia according to age group, sex, calendar year, and administrative region, with particular emphasis on age-standardized incidence rates (ASIRs). Methods A retrospective population-based descriptive study was conducted using data from the Saudi Cancer Registry. All primary bone cancer cases diagnosed between 2004 and 2020 were included. Incidence patterns were summarized using frequencies, age-specific incidence rates, crude incidence rates (CIRs), and ASIRs, stratified by sex, age group, year of diagnosis, and region. Statistical analyses were performed using SPSS software version 30. Results Between 2004 and 2020, a total of 2,275 primary bone cancer cases were recorded in Saudi Arabia, including 1,318 males (57.9%) and 957 females (42.1%). Bone cancer accounted for approximately 2.0% of all cancers among males and 0.9% among females. Mean ASIRs were higher in males (≈1.0 per 100,000) than females (≈0.7 per 100,000), while CIRs remained below 2.0 per 100,000 throughout the study period. Age-specific incidence showed a clear adolescent peak, most prominent in the 15–19-year age group, followed by the 10–14-year group. Regional variation in ASIRs was observed, with higher rates in Al-Jouf and Najran and persistently lower rates in Jazan. Conclusion Bone cancer in Saudi Arabia is rare but demonstrates distinct variation by sex, age, and region. The observed male predominance and adolescent peak are consistent with international epidemiological patterns. Continued enhancement of population-based cancer surveillance is essential to support accurate epidemiological assessment and informed public health planning.