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Risk factors for neuroblastoma

A risk factor is something that increases the risk of developing cancer. It could be a behaviour, substance or condition. Most cancers are the result of many risk factors. But sometimes neuroblastoma develops in children who don’t have any of the risk factors described below.

Neuroblastoma is the most common solid tumour outside of the brain in children. It accounts for 8%–10% of all cancers in children.

About 80% of neuroblastomas occur before the age of 5, and the average age at diagnosis is 2.5 years. It is the most common cancer in babies under the age of 1 year. Neuroblastoma is very rare in children over 10 years of age. This cancer occurs slightly more often in boys than in girls.

The following are risk factors for neuroblastoma. All of the known risk factors are not modifiable. This means that you can’t change or avoid them. Until we learn more about these risk factors, there are no specific ways you can reduce the risk.

Risk factors are generally listed in order from most to least important. But in most cases, it is impossible to rank them with absolute certainty.

Known risk factors

There is convincing evidence that the following factors increase the risk for neuroblastoma.

Family history

About 1%–2% of children diagnosed with neuroblastoma have a family history of the disease. The risk for neuroblastoma seems to be highest for siblings or an identical twin of children who already have the disease.

Genetic conditions

Genetic conditions are caused by changes to certain chromosomes. These chromosome changes are passed from parents to children. Neuroblastoma has been known to develop in children with the following genetic conditions, which involve changes in immature nerve cells (called neural crest cells, or neuroblasts). Other chromosome changes have also been found in children with neuroblastoma.

  • Hirschsprung’s disease is a condition in which nerves are missing from part of the intestines. As a result, the large intestine doesn’t work properly and can get blocked.
  • Congenital central hypoventilation syndrome (CCHS) is also called primary alveolar hypoventilation. It is a rare disorder that affects breathing. People with this disorder take shallow breaths, especially when they are sleeping.
  • Neurofibromatosis type 1 (von Recklinghausen disease) is a condition in which non-cancerous tumours develop in the nerves and skin, causing areas of the skin to become lighter or darker.
  • Beckwith-Wiedemann syndrome affects how different parts of the body grow. It causes large body size, large tongue, large organs, a defect in the abdominal wall and low blood sugar in newborns.
  • DiGeorge syndrome causes poor development of several body systems, which leads to medical problems such as heart defects, cleft palate and emotional and behavioural problems.

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Unknown risk factors

It isn’t known whether or not the following factors are linked with neuroblastoma. It may be that researchers can’t show a definite link or that studies have had different results. Further study is needed to see if the following are risk factors for neuroblastoma:

  • exposure to alcohol or certain medicines (including diuretics, pain medicines, antiseizure medicines, oral contraceptives and fertility hormones) during pregnancy
  • exposure to viruses or environmental factors (such as chemicals or radiation) during pregnancy or after birth
  • father’s occupational exposure in certain industries (including electronics-related jobs and jobs with exposure to electromagnetic fields, hydrocarbons or wood dust)
  • mother’s occupational exposure in certain industries (including farming, florist and garden workers and hair dressers)

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