Risks for childhood bone cancer

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

Osteosarcoma and Ewing sarcoma are the 2 main types of bone cancer that develop in children.

Several things could increase a child's risk for osteosarcoma. None of these risks can be changed. Until we learn more about these risks, there are no specific ways you can lower the risk for osteosarcoma.

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).

If your child has a genetic condition that increases their risk for osteosarcoma, they may need to visit their doctor more often. Talk to your doctor about your child's risk and if they need to have certain tests to check for osteosarcoma.

The following can increase the risk for osteosarcoma:

• Certain genetic conditions

• Previous radiation therapy

• Previous chemotherapy

• Certain bone diseases

A genetic condition is a disease caused by a change (mutation) in one or more genes. Having any of the following inherited genetic conditions increases 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. People with Li-Fraumeni syndrome tend to develop several different types of cancer before the age of 45.

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

Diamond-Blackfan anemia affects the bone marrow so it doesn't make enough healthy red blood cells. It increases the risk for leukemia and sarcoma, especially 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.

Children with cancer who are treated with a type of drug called an alkylating agent (a drug that kills cancer cells by damaging DNA) have a higher risk of developing osteosarcoma. This risk is 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 added to drinking water. Previous bone injuries or fractures are also not linked to osteosarcoma.

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. Until we learn more, there are no specific ways you can lower your child's risk for this type of cancer.