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Risks and causes of bone cancer

Your risk of developing cancer depends on many things including age, genetics, lifestyle and environmental factors.

Risk factors

We don’t know what causes most bone cancers. But there are some factors that may increase your risk of developing it.

Having any of these risk factors does not mean that you will definitely develop cancer.

Age

Like most cancers, the risk of bone cancer increases with age. But for some types of bone cancer, younger people have a higher risk.

Osteosarcoma is more common in adolescents (10 to 19 years). It seems to be linked to the growth of the bones during puberty.

Ewing sarcoma usually develops in children (0 to 14 years) and adolescents. But it can occur in adults.

Chondrosarcomas and spindle cell sarcomas tend to occur mostly in adults between the ages of 30 to 60. 

Chordomas are more common in adults over 50 years of age.

Cancer treatments

The risk of bone cancer is linked to previous cancer treatment with radiotherapy, particularly during childhood. Treatment with chemotherapy drugs called alkylating agents is also linked with osteosarcoma.

Other bone diseases

Some types of bone disease can increase the risk of bone cancer:

Enchondroma or osteochondroma

If you have a type of non cancerous (benign) bone tumour called an enchondroma or osteochondroma, you have an increased risk of getting a type of bone cancer called chondrosarcoma. This is very rare.

Ollier's disease 

People with a rare condition called Ollier's disease (also called enchondromatosis) develop many non cancerous (benign) tumours in their bones. These tumours can become cancerous, and can turn into a chondrosarcoma.

Paget disease

People with Paget disease have an increased risk of getting osteosarcoma. Paget disease is a condition where new bone replaces old bones at a faster than normal rate.

Genetic factors

Some genetic factors are linked to bone cancer:

Li-Fraumeni syndrome

A condition called Li-Fraumeni syndrome runs in families. It is caused by a gene fault inherited from your parents. If you have Li-Fraumeni syndrome, you have an increased risk of several cancers, including osteosarcoma. 

Hereditary retinoblastoma

There is a type of eye cancer also caused by faulty genes. It is called hereditary retinoblastoma. Children with this gene fault also have an increased risk of osteosarcoma.

Other syndromes

Syndromes such as Werner syndrome, Rothmund–Thomson syndrome and Bloom syndrome are also risk factors for osteosarcoma.

Injuries and knocks

People often think that a knock or injury to a bone can cause bone cancer. But research studies do not support this.

It's more likely that an injury causes swelling, which when it's investigated, shows up a cancer that is already there. Or a bone affected by cancer may be weakened and so is more likely to become broken (fractured) in an accident. Doctors may then spot the tumour when they investigate your fracture.

Other possible causes

Stories about potential causes are often in the media and it isn’t always clear which ideas are supported by evidence. There might be things you have heard of that we haven’t included here. This is because either there is no evidence about them or it is less clear.

For detailed information on bone cancer risks and causes

Last reviewed: 
08 Feb 2021
Next review due: 
08 Feb 2024
  • ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up: bone sarcomas

    P Casali and others

    Annals of Oncology, volume 29, supplement 4, p.79-95, October 2018

  • Cancer and its Management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2015

  • Cancer: Principles and Practice of Oncology (11th edition)

    VT De Vita, TS Lawrence and SA Rosenberg

    Lippincott, Williams and Wilkins, 2019

  • Osteosarcoma: Epidemiology, pathogenesis, clinical presentation, diagnosis, and histology

    L Wang and others

    UpToDate website

    Accessed February 2021

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact patientinformation@cancer.org.uk with details of the particular risk or cause you are interested in.