What are the possible causes of bone cancer?

Although bone cancer does not have a clearly defined cause, researchers have identified several factors that increase the likelihood of developing these tumors. Osteosarcoma occurs more frequently in people who have had high-dose external radiation therapy or treatment with certain anticancer drugs; children seem to be particularly susceptible. A small number of bone cancers are due to heredity.

For example, children who have had hereditary retinoblastoma (an uncommon cancer of the eye) are at a higher risk of developing osteosarcoma, particularly if they are treated with radiation. Additionally, people who have hereditary defects of bones and people with metal implants, which doctors sometimes use to repair fractures, are more likely to develop osteosarcoma.4


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Ewing sarcoma is not strongly associated with any heredity cancer syndromes, congenital childhood diseases, or previous radiation exposure.2

How often does bone cancer occur?

Primary bone cancer is rare. It accounts for much less than 1% of all cancers. About 2,300 new cases of primary bone cancer are diagnosed in the United States each year.5 Different types of bone cancer are more likely to occur in certain populations:

  • Osteosarcoma occurs most commonly between ages 10 and 19. However, people over age 40 who have other conditions, such as Paget disease (a benign condition characterized by abnormal development of new bone cells), are at increased risk of developing this cancer.
  • Chondrosarcoma occurs mainly in older adults (over age 40). The risk increases with advancing age. This disease rarely occurs in children and adolescents.
  • ESFTs occur most often in children and adolescents under 19 years of age. Boys are affected more often than girls. These tumors are extremely rare in African American children.

What are the symptoms of bone cancer?

Pain is the most common symptom of bone cancer, but not all bone cancers cause pain.1 Persistent or unusual pain or swelling in or near a bone can be caused by cancer or by other conditions. It is important to see a doctor to determine the cause.