Causes and Risk Factors of Osteosarcoma

Table of Contents
View All
Table of Contents

Although there are no specific, known causes of osteosarcoma, there are inherited and lifestyle factors that may increase a person's odds of developing this type of cancer.

Generally, healthcare professionals will take a holistic look at a person's genetics (height, race), unhealthy behaviors (lack of exercise, unhealthy eating), or past medical history (e.g., a former cancer diagnosis) to establish a diagnosis.

Notably, osteosarcoma primarily affects teenagers and adolescents. More than 75% of those diagnosed are under 25 years of age.

In this article, you'll learn about the risk factors associated with the development of osteosarcoma.

Doctor pointing to bone image

Luis Alverez / DigitalVision

Known Causes

Experts don't know the exact cause of osteosarcoma. Frustratingly, most of the known risk factors, including age and genetics, are out of a person's control. Other potential risk factors include:

  • Exposure to radiation: Being treated with radiation therapy for another type of cancer raises the risk of developing osteosarcoma in the affected area, often several years after treatment. Lower levels of radiation from imaging tests like X-rays and computed tomography (CT) scans, do not appear to pose the same risk.
  • Bone infarction: This occurs when blood supply is cut off from bone tissues, which can kill off bone cells and cause damage to your DNA (your hereditary material). It's unknown what causes bone infarcts.
  • Rapid bone growth: When a child or adolescent is going through a growth spurt, the risk of osteosarcoma is known to increase.


The majority of osteosarcoma are random, but certain genetic factors that cannot be avoided come with a slightly higher risk of developing the condition, including:

  • Height: Children and adolescents who are tall for their age are more at risk. This is thought to be due to DNA mutations that occur during growth spurts.
  • Gender: Males are more likely than females to develop the disease, though onset is earlier in females likely due to earlier development.
  • Race: Osteosarcoma occurs at slightly higher rates in Black populations than in White populations or other races. More research is needed as to why this is the case.

In addition to these genetic factors, a few rare inherited cancer syndromes have been linked to osteosarcoma, including:

  • Hereditary retinoblastoma: This is a rare eye cancer that typically affects children who have the gene mutation RB1. These children are also more likely to develop bone cancers, including osteosarcoma.
  • Rothmund-Thompson syndrome: This is a rare condition that is due to an abnormal REQL4 gene. Children with this inherited syndrome tend to have short stature and skin and skeletal problems, as well as a higher risk of getting osteosarcoma.
  • Li-Fraumeni syndrome: This syndrome is related to a mutation of the TP53 gene. People with this rare gene mutation are more likely to develop certain cancers, including breast cancer, brain tumors, and osteosarcoma.

Lifestyle Risk Factors

At this time, there are no known ways to prevent osteosarcoma. While lifestyle factors, such as stress, diet, lack of physical activity, and tobacco use, are known to play a role in the development of many adult cancers, these habits usually take decades to influence cancer risk.

As such, lifestyle factors are not thought to play a role in the development of childhood cancers like osteosarcoma.

Even adult cases of osteosarcoma are typically linked to another cause, such as a long-standing bone disease or another cancer that has spread.

A Word From Verywell

Osteosarcoma is very rare, accounting for 3% of childhood cancers. If you or a loved one are diagnosed with osteosarcoma, know that it's not your fault.

There's nothing you could have done to avoid the disease. Thankfully, advances in medical technology and treatment options are improving the capacity to catch this cancer early and increasing the odds of survival.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cleveland Clinic. Osteosarcoma.

  2. Sadykova LR, Ntekim AI, Muyangwa-Semenova M, et al. Epidemiology and risk factors of osteosarcoma. Cancer Invest. 2020;38(5):259-269. doi:10.1080/07357907.2020.1768401

  3. American Cancer Society. Osteosarcoma risk factors.

  4. Zhang C, Morimoto LM, de Smith AJ, et al. Genetic determinants of childhood and adult height associated with osteosarcoma riskCancer. 2018;124(18):3742-3752. doi:10.1002/cncr.31645

By Yvelette Stines
Yvelette Stines, MS, MEd, is an author, writer, and communications specialist specializing in health and wellness.