Bone Cancer Causes, Risk Factors, and Prevention
The exact cause of most bone tumors is not known. Scientists have found some genetic and environmental risk factors, but most people with bone cancer don’t have any known risk factors. A risk factor is anything that affects a person’s chance of getting a disease such as cancer.
Note: This information focuses on bone cancers that are seen most often in adults and start in the bones (primary bone cancers). Osteosarcoma, Ewing sarcoma, and bone metastases are covered separately.
What causes bone cancer?
Researchers have found some factors that increase the risk of bone cancer. But for the most part, it’s not clear exactly how these risk factors might cause bone cancer to develop. Research is underway to learn more.
We do know that specific gene changes (mutations) in normal bone cells, cartilage cells, and other cells of the musculoskeletal system are seen more frequently in certain types of bone cancer. These changes happen in genes that control cell growth or repair damaged DNA. This may cause those cells to form cancer.
Certain environmental factors may also increase the risk of developing bone cancer.
Genetic risk factors for bone cancer
Most gene changes (mutations) that cause bone cancer happen during a person’s lifetime. These are called acquired mutations. Only a small number of people inherit gene mutations from a parent that increase their risk of bone cancer.
Share any family history of cancer with your care team. They can help you determine if genetic testing might be useful. You can also read more in Genetics and Cancer.
Inherited gene mutations, by cancer type
Researchers have found inherited gene mutations that increase the risk of some types of bone cancer.
There are a few inherited gene changes that can increase the risk of developing osteosarcoma. This includes conditions like Li-Fraumeni syndrome, hereditary retinoblastoma, Rothmund-Thompson syndrome, and other genetic disorders.
To learn more, see Causes, Risk Factors, and Prevention of Osteosarcoma.
Hereditary Multiple Osteochondromas (Multiple Hereditary Exostoses)
This disease is often caused by an inherited gene change in a tumor suppressor gene called EXT1 or EXT2. The condition causes the growth of multiple osteochondromas on the bones of the body.
Osteochondromas are benign (not cancer), but about 5% of osteochondromas will transform into chondrosarcoma.
Ollier Disease/Maffucci Syndrome
These diseases are caused by changes in the IDH1 or IDH2 genes.
- Ollier disease is characterized by the growth of enchondromas, benign cartilage tumors.
- Maffucci syndrome is characterized by the growth of enchondromas and hemangiomas (benign blood vessel tumors).
About 50% of people with these rare conditions will have an enchondroma tumor transform into a chondrosarcoma during their life.
Researchers have not yet found inherited gene changes that increase the risk of having Ewing sarcoma. For more information, see Causes, Risk Factors, and Prevention of Ewing sarcoma.
Researchers have not yet found inherited gene changes that increase the risk of these rare tumors.
Researchers have not yet found inherited gene changes that increase the risk of this rare tumor.
Giant cell tumors have been seen in people with Noonan syndrome, a genetic condition that affects growth and development. This condition can cause people to be shorter than average, have unique facial features and delays in development, and have problems with the heart, kidneys, and bones.
Most chordomas don’t have a known cause, but a small number of chordomas seem to run in families. This is known as familial chordoma. It is often linked to a change (mutation) in the TBXT gene that a person inherits from a parent.
People with tuberous sclerosis seem to have a high risk of chordoma during childhood, although this seems to be rare overall. Tuberous sclerosis is an inherited syndrome caused by a defect (mutation) in either the TSC1 or TSC2 gene.
Other conditions
Scientists have also found that conditions where the bones grow or remodel often may increase the risk of bone cancer.
For example, Paget’s disease of the bone is a condition that causes bones to turn over quickly, leading to weaker and enlarged bones. People with Paget’s disease may be at a higher risk of certain bone tumors like osteosarcoma or giant cell tumors of the bone. In some cases, Paget’s disease runs in families, but for many people the cause is not completely understood.
Environmental risk factors
An environmental risk factor is something in your surroundings that increases your risk of getting a disease like cancer. A few environmental risk factors are associated with bone cancer.
Previous radiation therapy
People who received radiation therapy, usually to treat another type of cancer, have a slightly increased risk of developing bone cancer in the area that was treated.
This risk is higher in people who were treated at a younger age, especially in childhood, and those who were treated with higher doses of radiation. These cancers tend to develop many years after radiation therapy, often decades later.
Most often these are osteosarcomas, but sometimes these are less common types of bone cancer such as fibrosarcoma of the bone or undifferentiated pleomorphic sarcoma (UPS) of bone.
Previous chemotherapy
Treatment with alkylating chemo drugs has been associated with developing bone cancers like osteosarcoma in people previously treated for another cancer with these drugs. Alkylating chemo drugs include cyclophosphamide, ifosfamide, busulfan, melphalan, and others.
Other risk factors
Age and race may also be risk factors for some types of bone cancer.
Age
Some types of bone tumors may be more or less common, depending on your age. For example:
- Osteosarcoma and Ewing sarcoma are more common in children and young adults.
- Chondrosarcomas are more common in older adults.
Race
Bone tumors overall are more common in White people than people of other races. However, osteosarcoma is more common in Black and Hispanic people than in other races.
Can bone cancer be prevented?
Most known risk factors for bone cancer cannot be changed, including age, certain bone diseases, and inherited conditions. There are no known lifestyle-related or environmental causes of bone cancer other than exposure to prior radiation or chemotherapy. So at this time, there is no way to protect against most bone cancers.
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- References
Developed by the P站视频 medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Cohen MM Jr, Gorlin RJ. Noonan-like/multiple giant cell lesion syndrome. Am J Med Genet. 1991;40(2):159-166.
Cole S, Gianferante DM, Zhu B, Mirabello L. Osteosarcoma: A Surveillance, Epidemiology, and End Results program-based analysis from 1975 to 2017. Cancer. 2022;128(11):2107-2118.
Gelderblom AJ, Bovee J. Chondrosarcoma. UpToDate. 2025. Accessed at https://www.uptodate.com/contents/chondrosarcoma on October 8, 2025.
Karbach J, Coerdt W, Wagner W, Bartsch O. Case report: Noonan syndrome with multiple giant cell lesions and review of the literature. Am J Med Genet A. 2012;158A(9):2283-2289.
National Cancer Institute. Ewing Sarcoma Treatment. Accessed at https://www.cancer.gov/types/bone/hp/ewing-treatment-pdq on October 7, 2025.
National Cancer Institute. Osteosarcoma and UPS of Bone Treatment. Accessed at https://www.cancer.gov/types/bone/hp/osteosarcoma-treatment-pdq on October 7, 2025.
National Cancer Institute. SEER Cancer Stat Facts: Bone and Joint Cancer. Accessed at https://seer.cancer.gov/statfacts/html/bones.html on October 8, 2025.
Rendina D, Mossetti G, Soscia E, et al. Giant cell tumor and Paget's disease of bone in one family: geographic clustering. Clin Orthop Relat Res. 2004;(421):218-224.
Last Revised: January 5, 2026
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