Twenty-Year Infodemiology of Bone Sarcomas in France (2006-2026): Celebrity Effect, Lexical Gap, and Limited Online Impact of Awareness Campaigns.

BACKGROUND: Primary bone sarcomas - osteosarcoma, Ewing sarcoma, and chondrosarcoma - are rare malignant tumours with insufficient public awareness. Infodemiology through Google Trends (GT) enables analysis of population-level interest in these entities over time. No French analysis covering a long observation period has been published. This study addresses three specific questions: (1) Is celebrity-driven media exposure the primary driver of public online interest in bone sarcomas? (2) Do Sarcoma Awareness Month campaigns (July) generate a measurable increase in search volume? (3) Is there a quantifiable lexical gap between lay and expert terminology, and what are its implications? METHODS: Monthly GT data (June 2006 - June 2026, n = 241 months) were extracted using both "terms" and "topics" modes for five query groups: osteosarcoma, Ewing sarcoma, sarcoma (generic term), chondrosarcoma, and lay terminology ("bone cancer", "bone tumour"). Secular trends were analysed by linear regression, the July effect by Mann-Whitney test, and inter-entity correlations by Spearman coefficient, with multiplicity correction using the Benjamini-Hochberg false discovery rate (FDR) procedure. RESULTS: Lay terminology generated a median Search Volume Index (SVI) of 56 [51-60] versus 14 [11-18] for osteosarcoma, 8 [2-11] for Ewing sarcoma, and 4 [3-5] for chondrosarcoma (×13 gap vs chondrosarcoma). The osteosarcoma series showed a sustained high-volume period temporally associated with the media trajectory of Xana Martínez (peak ×7.1 above baseline, August 2019); as Google Trends measures online search behaviour rather than direct campaign or media exposure, these associations remain descriptive. Ewing sarcoma showed the strongest secular trend (R² = 0.253). No July effect was significant after FDR correction for any group (all q ≥ 0.373). All inter-entity sarcoma correlations were significant (q < 0.001). Two of four lay-sarcoma correlations were non-significant (ρ = -0.142 to -0.124, NS); Ewing sarcoma and generic sarcoma each showed a significant negative correlation with lay terminology (ρ = -0.265 and -0.153 respectively, both q < 0.05). DISCUSSION: Public interest in bone sarcomas over twenty years has been structured by celebrity events rather than institutional campaigns. The lexical gap (×13 vs chondrosarcoma, ×4.0 vs osteosarcoma) and the near-invisibility of chondrosarcoma have direct implications for NETSARC + communication strategy and diagnostic delay reduction. LEVEL OF EVIDENCE: IV; Retrospective observational study (analysis of publicly available data).