Epidemiology of Bone Cancer in Children

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Abstract
In a search for etiologic clues to primary bone cancer in childhood, we examined 1,532 death certificates of all children in the United States dying from these neoplasms, 1960–66, and 396 hospital charts from 12 institutions. Mortality from osteogenic sarcoma did not differ by race, whereas mortality from Ewing's sarcoma was virtually absent among nonwhite children. Bone tumors increased progressively with age through childhood and adolescence. Girls had slightly higher rates at the start of adolescence, but much lower rates after 15 years. There were no time-space variations to suggest environmental factors, such as infectious agents or radioactive materials resulting from the testing of nuclear weapons. Bone cancer seemed related to a variety of antecedent skeletal defects, but not to nonskeletal anomalies. Retinoblastoma occurred in 2 children with osteogenic sarcoma, and neoplasms of bone and brain seemed unduly frequent among close relatives. Thus the pathogenesis of bone cancer in children is influenced by race, sex- and age-associated factors correlated with skeletal growth, preexisting bone defects, and genetic and/or environmental influences underlying family aggregates.

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