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% to 10% of all cancers in children.

About 80% of neuroblastomas occur in children under 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. These risk factors are not modifiable, which means you cannot change 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.

Risk factors

Family history

Certain genetic conditions

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

Family history

About 1% to 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. In most children with a family history of neuroblastoma, there are genetic mutations in the anaplastic lymphoma kinase (ALK) gene.

Certain genetic conditions

Children with the following genetic conditions have a higher risk of developing neuroblastoma. Talk to your doctor about your child’s risk. If your child has a genetic condition that increases the risk of neuroblastoma, your child may need to visit the doctor more often to check for neuroblastoma. Your doctor will recommend what tests your child should have and how often to have them.

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) affects the development and growth of nerve cells and causes tumours to develop in the nerves and skin. Children with neurofibromatosis type 1 have a higher risk of developing certain cancers, including neuroblastoma.

Beckwith-Wiedemann syndrome affects how different parts of the body grow. Children with this syndrome are born much larger than normal. They grow and gain weight at an unusual rate during childhood. Children with Beckwith-Wiedemann syndrome have a higher risk of developing certain cancers, including neuroblastoma.

Li-Fraumeni syndrome greatly increases a child’s risk of developing several types of cancer, including neuroblastoma.

Costello syndrome affects many parts of the body. Children with Costello syndrome often have delayed development, intellectual disability, a characteristic facial appearance, loose folds of extra skin and unusually flexible joints. Children with Costello syndrome have a higher risk of developing certain cancers, including neuroblastoma.

Questions to ask your healthcare team

Ask your child’s healthcare team questions about risks.

Expert review and references

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  • National Cancer Institute. Neuroblastoma Treatment (PDQ®) Health Professional Version. Bethesda, MD: National Cancer Institute; 2014.
  • Ross, J.A. & Spector, L.G . Cancers in children. Schottenfeld, D. & Fraumeni, J. F. Jr. (Eds.). Cancer Epidemiology and Prevention. 3rd ed. New York: Oxford University Press; 2006: 65: 1252-1268.
  • Wang LL, Yustein J, Louis C, et al . Solid tumors of childhood. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011: 123: pp. 1760-92.