Children, Cancer, and the Environment

Malignant bone tumors (Ewings sarcoma and osteosarcoma)

There are two principal kinds of bone cancers - osteosarcoma and Ewings sarcomas.

The incidence of Ewings sarcoma is much higher among whites than African-Americans in the US.  The reasons for these differences are not known.

Ionizing radiation is known to be a cause of osteosarcoma (1) and may also cause Ewings sarcoma, though the evidence is less clear.  Children who are first diagnosed with retinoblastoma and some other cancers are at increased risk for osteosarcoma.

Little is known about other causes of the diseases.  Beryllium is known to cause osteosarcoma in animal experiments, but data are not available for humans (2).

The bone cancers seem to occur in conjunction with growth spurts experienced in adolescence.  One study found that risk increased with height (3).  However, any mechanism by which these events may be linked is not known. 

Children with Ewing's sarcoma are also more likely than other children to have been born with hernias.  This suggests that both events may originate in a disruption of normal development of the embryo, either as a result of an exposure that occurs in utero or some other developmental problem (4).

Only a few studies have been conducted of possible environmental cause of these bone cancers.

·        Children with fathers who worked in agriculture had a 9-time greater risk of having the disease than other children.   A small study in California of 43 children with Ewing's sarcoma found that children with fathers exposed to pesticides or who worked with pesticides had a greater risk of the disease (5)

·        A recent study by the Children’s Cancer Group found no link between the disease and parents who were exposed to solvents, paints, metals, welding, mining or other chemicals.  It is unclear whether pesticides were included among the other chemicals (6).

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1.  Le Vu B, de Vathaire F, Shamsaldin A, Hawkins MM, Grimaud E, Hardiman C, Diallo I, Vassal G, Bessa E, Campbell S, Panis X, Daly-Schveitzer N, Lagrange JL, Zucker JM, Eschwège F, Chavaudra J, Lemerle J. Radiation dose, chemotherapy and risk of osteosarcoma after solid tumours during childhood. International Journal of Cancer 1998; 77:370-7.

2.  IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Beryllium, cadmium, mercury, and exposures in the glass manufacturing industry. Lyon: International Agency for Research on Cancer, 1993.

3.  Gelberg KH, Fitzgerald EF, Hwang S, Dubrow R. Growth and development and other risk factors for osteosarcoma in children and young adults. International Journal of Epidemiology 1997; 26:272-8.

4.    Cope JU, Tsokos M, Helman LJ, Gridley G, Tucker MA. Inguinal hernia in patients with Ewing sarcoma: a clue to etiology. Medical and Pediatric Oncology 2000; 34:195-9.

5. Holly EA, Aston DA, Ahn DK, Kristiansen JJ. Ewing's bone sarcoma, paternal occupational exposure, and other factors. American Journal of Epidemiology 1992; 135:122-9.

6.  Buckley JD, Pendergrass TW, Buckley CM, Pritchard DJ, Nesbit ME, Provisor AJ, Robison LL. Epidemiology of osteosarcoma and Ewing's sarcoma in childhood: a study of 305 cases by the Children's Cancer Group. Cancer 1998; 83:1440-8.

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