e13099Background: Solid tumors frequently metastasize to bone, which can lead to serious bone complications. Population-based estimates of bone metastasis incidence are limited, often based on autopsy data, and may not reflect recent treatment advances. Methods: Electronic medical records (OSCER, Oncology Services Comprehensive Electronic Records, 569,000 patients, 52 US cancer centers) were used to identify patients ≥18 years newly diagnosed with a solid tumor between 1/1/2004 and 12/31/2013, excluding patients with hematologic tumors or multiple primaries. Kaplan-Meier analyses quantified bone metastasis incidence with follow-up censored at last clinic visit, new primary tumor, bone metastasis, or 12/31/2014. Estimates were stratified by tumor type, stage at diagnosis, and calendar year. Results: Among 382,733 patients (mean age 64 years; mean follow-up 940 days), breast (36%), lung (15%), and colorectal (12%) tumors were most common. Mean time to bone metastasis was 410 days, with 1-year incidence 4.6%...