Risks for childhood bone cancer

Certain behaviours, substances or conditions can affect your risk, or chance, of developing cancer. Some things increase your risk and some things decrease it. Most cancers are the result of many risks. But sometimes cancer develops in people who don't have any risks.

There are 2 main types of bone cancer that develop in children. The types are osteosarcoma and Ewing sarcoma.

The chance that this cancer will develop is highest during the growth spurt in the teenage years. It occurs slightly more often in boys and in Black children (including children of African or Caribbean ancestry).

The following can increase the risk for osteosarcoma.

Certain inherited genetic syndromes

Previous radiation therapy

Previous chemotherapy

Certain bone diseases

Genetic syndromes are diseases or disorders caused by a change (mutation) in one or more genes. Having the following inherited genetic syndromes can increase a child’s risk of developing osteosarcoma.

Familial retinoblastoma is an inherited form of retinoblastoma, which is an eye cancer that occurs in children. Children with familial retinoblastoma have a higher risk of developing osteosarcoma and soft tissue sarcoma.

Li-Fraumeni syndrome is associated with an increased risk of developing certain types of cancers, including breast cancer, brain tumours, acute leukemias, soft tissue and bone sarcomas and adrenal cortical carcinomas.

Rothmund-Thomson syndrome causes skin rashes, thinning skin, small groups of blood vessels under the skin (telangiectasia) and bone problems. It increases the risk of developing osteosarcoma.

Werner syndrome causes the body to age very rapidly after puberty. It increases the risk for melanoma, bone, soft tissue and thyroid cancers.

Bloom syndrome causes shorter than average height, a high-pitched voice and a characteristic facial appearance. It is associated with an increased risk of developing cancer, including leukemia, lymphoma, breast, cervical, colon, stomach, laryngeal, non-melanoma skin cancers and osteosarcoma, as well as Wilms tumour. People with Bloom syndrome often develop several different types of cancer.

Diamond-Blackfan anemia affects the bone marrow. It also increases the risk for osteosarcoma.

Neurofibromatosis type 1 affects the nervous system. It affects the development and growth of neurons (nerve cells), causes tumours (neurofibromas) to grow on nerves and may cause other abnormalities in muscles, bones and skin. Sometimes cancerous tumours called malignant peripheral nerve sheath tumours may grow along the nerves. Neurofibromatosis type 1 increases the risk for neuroendocrine tumours, soft tissue sarcoma, osteosarcoma, brain tumours, leukemia and neuroblastoma.

Children who had radiation therapy have a higher risk of developing osteosarcoma in the area that was treated. The risk is greater if higher doses of radiation therapy were used and if the child was treated at a young age. Osteosarcoma typically develops 5 to 20 years after radiation therapy.

Children who had certain types of chemotherapy have a higher risk of developing osteosarcoma. This risk may be even higher if the child also received radiation therapy.

Children who have Paget disease of the bone or other bone diseases have a higher risk of developing osteosarcoma later in life (usually as an adult).

Significant evidence shows no link between osteosarcoma and fluoride use or previous bone injury or fracture.

Ewing sarcoma usually develops during the teenage years and is slightly more common in boys than in girls. It occurs more frequently in white children and is rare in Black children (including children of African or Caribbean ancestry).

There are no known risks for Ewing sarcoma.