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Document Type

Article

Abstract

Clinical case series and descriptive epidemiologic studies have suggested a rela­tionship between childhood bone cancers and accelerated skeletal growth, but definitive studies are lacking. Anthropometric studies of osteosarcoma and Ewing’s sarcoma cases and normal controls, along with their families, are needed to assess the role of growth and maturation. Some descriptive epidemiologic features of these two histologic types of childhood bone cancer are reviewed, along with evidence for the role of hormones (i.e., growth hormone, somatomedins, androgens). Theoretical mechanisms involving hormones are outlined including their possible role as promoters or as factors interacting with environmental agents (such as ionizing radiation). Clinical-epidemiologic studies of families prone to osteosarcomas and to constellations of cancers (and/or skeletal diseases and malformations) may aid in distinguishing genetic and environmental factors and defining specific mechanisms (e.g., hormonal, cytogenetic) of susceptibility. Our understanding of the etiologies of osteosarcoma and Ewing’s sarcoma in children may depend on the integration of knowledge from various areas, including: the differentiation and growth of bone cells and their precursors; the hormonal control of human skeletal growth and maturation; epidemiologic studies of exposures to environmental agents; clinical-epidemiologic studies of families prone to certain cancers; and developments regarding the role of oncogenes and cytogenetic abnormalities in spe­cific cancers.

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