Global, Regional, and National Trends of Pediatric Soft Tissue and Other Extraosseous Sarcomas, 1990 to 2021: A GBD Study

This study assessed global trends, structural drivers, and health disparities in pediatric soft tissue and other extraosseous sarcomas (0 to 14 y) from 1990 to 2021 using Global Burden of Disease data. Joinpoint regression, Das Gupta decomposition, Age-Period-Cohort modelling, health inequality indices, and ARIMA forecasting were employed. Globally, incidence and death rates declined significantly to 0.37 and 0.15 per 100,000 in 2021, respectively, primarily driven by epidemiological improvements. However, neonates (<28 d) persistently bore the highest burden and the slowest improvement rate. Low-sociodemographic index (SDI) regions faced the highest absolute burden but achieved the fastest progress. While absolute health inequality narrowed substantially since 1990, relative inequality worsened slightly, indicating a persistent concentration of disease in disadvantaged populations. ARIMA models project continued global declines through 2036. Although the global pediatric sarcoma burden has improved, deep-seated disparities remain. Targeted diagnostic and therapeutic interventions are urgently required for neonates, alongside enhanced health care resource allocation in low-SDI and underperforming high-SDI subnational regions.