Risks for bone cancer

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 bone cancer develops in people who don’t have any of the risk factors described below.

Some people can have a higher than average risk for bone cancer. Talk to your doctor about your risk. If you are at higher than average risk, you may need a personal plan for testing.

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

Research shows that there is no link between fluoride in drinking water and a higher risk for bone cancer.

There is convincing evidence that the following factors increase your risk for bone cancer.

People who are exposed to high doses of radiation are at a greater risk of bone cancer. Bone cancer usually occurs between 5 and 20 years after exposure.

High-dose radiation therapy given to treat people who had cancer at a young age can increase the risk for bone cancer. The risk is greatest in the area that was treated with radiation. People who had their entire body treated with radiation (called total body irradiation) before a stem cell transplant have the highest risk of developing bone cancer.

Ionizing radiation from atomic bombs causes a high risk for bone cancer, especially for people who were children when they were exposed.

Exposure to radium increases the risk for bone cancer.

• People with bone diseases, such as alkylating spondylitis and bone tuberculosis, who were treated with intravenous radium have a high risk for bone cancer.
• Radium paint is used on the dials of watches and faces of clocks. Workers who used their lips to bring the paintbrushes to a point have a high risk of bone cancer.

Exposure to plutonium can increase the risk for bone cancer. People who work or live near plutonium production plants and around nuclear weapons factories have a higher risk of bone cancer.

Having one of the following bone disorders or conditions can increase the risk for bone cancer.

Paget disease of the bone causes abnormal bone tissue to form. The bones become heavier, thicker, weaker and more likely to break than normal. Paget disease most often affects people over the age of 50.

Fibrosis dysplasia is a chronic condition where bones grow unevenly and break easily.

Osteogenesis imperfecta is a disorder where the bones break easily.

Chondroma and osteochondroma are non-cancerous (benign) bone tumours that slightly increase the risk of chondrosarcoma, a type of bone cancer.

The following rare inherited genetic conditions increase the risk of bone cancer.

Retinoblastoma is a rare eye cancer that occurs in children. It can be hereditary (called familial retinoblastoma). People who have the inherited form of retinoblastoma as children have a higher risk of developing bone cancer. This risk is even higher for people who were given both chemotherapy and radiation therapy as part of their treatment for retinoblastoma.

Li-Fraumeni syndrome greatly increases the risk of developing several types of cancer, including bone cancer.

Werner syndrome is a very rare condition that causes the body to age very rapidly after puberty. People with Werner syndrome usually develop bone cancers, often at the ankle, during their mid-30s.

Rothmund-Thomson syndrome causes short stature, skeletal problems and skin rashes. People with this genetic condition have a higher risk of developing osteosarcoma, especially in childhood or adolescence.  

Bloom syndrome is characterized by dwarfism, rash, immunodeficiency and the risk of developing different types of cancer, including bone cancer.

Hereditary multiple exostoses (HME) is a rare condition that causes many non-cancerous lumps (called exostoses) to grow on the bones. These lumps can be painful and cause bones to deform or break. People with HME have a slightly higher risk of developing bone cancer later in life.

Children with cancer who are treated with a type of drug called an alkylating agent have a higher risk of developing bone cancer later in life. The risk increases with the amount of the drug given.

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

• previous injuries or fractures
• surgical implants and other foreign objects
• exposure to chemicals
• SV40 virus

To make the decisions that are right for you, ask your healthcare team questions about risks.