Causes of osteosarcoma
This information has been written for patients, their families and friends and the general public to help you understand more about what may cause osteosarcoma.
What causes osteosarcoma and are there any risk factors?
There has been a lot of research into possible causes of osteosarcoma but the underlying cause remains unknown in most cases. However, in 10-15% of people, a possible cause can be identified.
Identified causes include:
- Previous radiotherapy (radiation treatment) for other cancers,
- Bones which already have something wrong with them (underlying bone abnormalities),
- A 'genetic predisposition' - there is something wrong with a gene that runs in families and makes a person more likely to develop a cancer, or a person has a particular combination of forms (alleles) of specific genes.
During adolescence, bones grow very quickly. It is thought that this rapid bone growth may be part of the reason why young people develop osteosarcoma more often during adolescence than younger children or older adults.
Osteosarcoma is also common in the long bones of large dogs, such as Great Danes and Irish Wolfhounds. This may be further evidence of a link between rapid bone growth and osteosarcoma.
Research has shown that patients who develop osteosarcoma are more likely to be taller than people of average height, again suggesting a link with rapid bone growth.
Older people can also get osteosarcoma, particularly those who suffer from a condition called Paget's disease of the bone.
An earlier bone injury (trauma) has been suggested as a possible cause of osteosarcoma. But, most experts now think that injury draws attention to the tumour rather than causing it.
A risk factor is something that can increase the chance of getting an illness.
Osteosarcoma risk factors
Age, height and gender
- Osteosarcoma is more common in people between 10 and 24 years old,
- You have a slightly higher risk of getting osteosarcoma if you are tall for your age,
- Males have a slightly higher risk compared to females.
Inherited risk factors:
These are risk factors that people can be born with. They can be passed on from one or both parents. The risk is passed to the child through the parent's genes. So, just as children inherit features such as hair or eye colour from their parents, they can inherit a risk that will increase their chance of getting osteosarcoma.
- Retinoblastoma (REH-tih-noh-blas-TOH-muh): this is a rare childhood eye tumour; it can be caused by damage to a gene called the retinoblastoma (Rb) gene, which in some cases can be passed on from parents. This gene normally keeps cells from dividing too quickly or in an uncontrolled way but if the gene is damaged then the chance of developing cancer increases. Children who have had retinoblastoma have a higher risk of osteosarcoma. It is thought that around 12% of retinoblastoma patients may develop osteosarcoma.
- Li-Fraumeni (LEE-frau-MAY-nee) syndrome: This condition is named after two doctors who described a number of families where several family members had developed different types of cancer. The condition is caused by damage to a gene called p53. The normal p53 gene, Tumour Suppressor Gene helps to keep any abnormal cells under control by helping to kill them and stop them growing. If the gene is damaged then it does not work properly and cannot do this. This may allow abnormal cells to grow and makes cancer more likely to develop.
If a parent has Li-Fraumeni Syndrome, then their children may inherit the altered gene. Li-Fraumeni Syndrome is inherited in what is known as an autosomal dominant pattern. This means only one copy of the altered p53 gene is needed to increase the risk of developing cancer and there is a 50% chance that the gene will be inherited. Families with this risk factor may have several family members who have developed different cancers at a young age. One of the many cancers that can develop is osteosarcoma.
People with other very rare conditions have an increased risk of osteosarcoma. These include Rothmund-Thomson syndrome, which affects many parts of the body (slow growth, skin rashes, delayed bone formation and bones that do not form normally) and Werner's syndrome, which is a condition that starts around the time of puberty and leads to the appearance of old age by 30-40 years of age.
Environmental risk factors
- The only established environmental risk factor is from exposure to ionising radiation from previous treatment for cancer.
There has been some research into other possible environmental risk factors such as exposure to fluoride and pesticides, and previous treatments with chemotherapy drugs. More research is needed before we will know if these are risk factors. The Bone Cancer Research Trust is funding some of this research.
Other malignancies and bone diseases
- Paget's disease of bone (usually adults over the age of 55). Paget's is a disease that makes bones painful and encourages bone cells to divide more rapidly. Around 2% of patients with Paget's develop osteosarcoma.
Information about what causes a disease is called 'aetiology' (EE-tee-OL-loh-jee).
Last reviewed: October 2010; Version: 1.1
Review due: October 2011
The authors and reviewers of this information are committed to producing reliable, accurate and up to date content reflecting the best available research evidence, and best clinical practice. We aim to provide unbiased information free from any commercial conflicts of interest. This article is for information only and should not be used for the diagnosis or treatment of medical conditions. BCRT can answer questions about primary bone cancers, including treatments and research but we are unable to offer specific advice about individual patients. If you are worried about any symptoms please consult your doctor.
