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We estimated the risk of subsequent bone cancer among 9170 patients who had survived two or more years after the diagnosis of a cancer in childhood.

As compared with the general population, the patients had a relative risk of 133 (95 percent confidence interval, 98 to 176) and a mean (±SE) 20-year cumulative risk of 2.8±0.7 percent. Detailed data on treatment were obtained on 64 patients in whom bone cancer developed after childhood cancer. As compared with 209 matched controls who had survived cancer in childhood but who did not have bone cancer later, patients who had had radiation therapy had a 2.7-fold risk (95 percent confidence interval, 1.0 to 7.7) and a sharp dose–response gradient reaching a 40-fold risk after doses to the bone of more than 6000 rad. The relative dose–response effect among patients who had been treated for retinoblastoma resembled that among patients with all other types …