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Adrenal Cancer Causes, Risk Factors, and Prevention
Learn about the risk factors for adrenal cancer. The cause of most adrenal cancer is not completely understood, but knowing whether you have risk factors might be helpful.
For information on neuroblastoma, a cancer that often begins in the inner part of adrenal glands, see Causes, Risk Factors, and Prevention of Neuroblastoma.
What causes adrenal cancer?
We do not know exactly what causes most adrenal cancers.
Researchers have made great progress in understanding how certain gene changes (mutations) can cause normal cells to become cancerous. For example, some genes contain instructions that control when cells grow and divide. Changes in these genes can lead to cancer growth.
Examples of gene changes seen in adrenal cancer cells include:
- Changes in the IGF2 gene, or insulin-like growth factor 2 gene, which is one of the more common gene changes seen in adrenal cancer.
- Inherited changes in the TP53 gene, a condition called Li Fraumeni Syndrome, cause more than half of adrenocortical carcinomas in children and a small number in adults (about 1 out of every 20). Some other adrenal cancers have also been found to have TP53 gene changes that were not hereditary but happened by chance after birth.
- Changes in the ZNRF3 gene have also been seen in adrenal cancers.
Most gene changes in cancer cells are acquired. They occur by chance or because of something in the environment. The causes of all gene changes are not known.
Some gene changes are hereditary, meaning they are present in cells throughout the body and can be passed in families.
To learn more, see Genes and Cancer.
What are risk factors for adrenal cancer?
A risk factor is anything that increases your chances of getting a disease, such as cancer. Different cancers have different risk factors.
Researchers have found a few risk factors that make a person more likely to develop adrenal cancer. But having a risk factor doesn’t mean you’ll get the disease. Most people with risk factors don’t develop adrenal cancer.
Certain adrenal cancer risk factors that are related to personal behaviors, such as smoking, can be changed. Others, like a person’s age, genetics, and family history can’t be changed.
General risk factors
People with certain characteristics might be more likely to have adrenal cancer.
Adrenocortical carcinomas are rare but occur more in women than men.
Adrenocortical carcinomas are more common in children under age 5 and adults in their 40s and 50s.
Genetic syndromes
Some people have gene changes in cells throughout their body. These can be inherited from a parent. Or these changes can occur randomly before the person is born, increasing their risk of adrenal tumors or cancer.
This is a rare condition caused by a change in the TP53 gene. It causes more than half of adrenocortical carcinomas in children and a small number in adults (about 1 out of every 20). Some other adrenal cancers have also been found to have TP53 gene changes that were not inherited but happened by chance after birth.
People with Li-Fraumeni syndrome have a high risk of developing several kinds of cancer, including leukemia, breast cancer, bone cancer, brain tumors, and adrenocortical cancer.
People with Beckwith-Wiedemann syndrome have an increased risk for developing neuroblastoma and adrenal cortex cancers, as well as childhood cancers of the kidney and liver.
This syndrome is caused by changes in a gene called APC. People with this syndrome can develop hundreds of polyps in the large intestine. These polyps will lead to colon cancer if the colon is not removed. FAP patients may also develop tumors in other places like the adrenal glands. But most adrenal tumors in people with FAP are noncancerous growths (adenomas).
Lynch syndrome is an inherited genetic disorder that increases the risk of colorectal cancer, stomach cancer, adrenocortical cancer, and some other cancers. Lynch syndrome is sometimes called hereditary nonpolyposis colorectal cancer (HNPCC). In most cases, this disorder is caused by a defect in one of several genes, including MLH1, MSH2, MSH6, PMS2, and EPCAM.
These conditions cause tumors of the autonomic nerves and adrenal medulla (paragangliomas and pheochromocytomas) to develop. They can be caused by several gene changes. However, changes in the SDHB gene can significantly increase the chance of developing a cancerous (malignant) pheochromocytoma.
People with multiple endocrine neoplasia type 2 (MEN2) have a higher risk of cancers of the endocrine system, including pheochromocytomas (adrenal tumors).
VHL is caused by a change in the VHL gene. This change can increase the chance of developing pheochromocytomas (adrenal tumors), other tumors, and some cancers.
NF1 is caused by a change in the NF1 gene. This condition most often causes benign (not cancer) tumors of the skin, nerves, soft tissues, and bones. However, it can also increase the risk of having a pheochromocytoma.
Lifestyle and environmental factors
Some risk factors may affect a person’s chance of developing adrenal cancer, but their exact impact is not well understood. These include having excess body weight, being physically inactive, and being exposed to cancer-causing substances in the environment.
Smoking has also been suggested as a risk factor, specifically in adult men.
Can adrenal cancer be prevented?
Most cases of adrenal cancer cannot be prevented.
However, it is always important to follow general recommendations to lower cancer risk, such as:
- Avoid smoking.
- Avoid exposure to cancer-causing chemicals.
- Stay at a healthy body weight.
- Take part in daily activity.
If you have a family cancer syndrome that increases your risk of adrenal cancer, talk with your doctor about any testing they might recommend to find and treat adrenal tumors and cancer early, when treatment is more likely to be successful.
- Written by
- References
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.
Asban A, Patel AJ, Reddy S, Wang T, Balantine CJ, Chen H. Chapter 68: Cancer of the Endocrine System. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa. Elsevier: 2020.
Else T. Association of adrenocortical carcinoma with familial cancer susceptibility syndromes. Mol Cell Endocrinol. 2012;351(1):66-70.
Habra MA, Sukkari MA, Hasan A, et al. Epidemiological risk factors for adrenocortical carcinoma: A hospital-based case-control study. Int J Cancer. 2020;146(7):1836-1840.
Lacroix A. Clinical Manifestations and diagnosis of adrenocortical carcinoma. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-adrenocortical-carcinoma on June 23, 2026.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Neuroendocrine and Adrenal Tumors Version 1.2026 – April 21, 2026. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf on June 23, 2026.
Sarrafan-Chaharsoughi Z, Yazdian Anari P, Malayeri AA, Naraev B, Del Rivero J. Update on Adrenocortical Carcinoma. Urol Clin North Am. 2025;52(2):275-286.
Turin CG, Crenshaw MM, Fishbein L. Pheochromocytoma and paraganglioma: germline genetics and hereditary syndromes. Endocr Oncol. 2022;2(1):R65-R77. Published 2022 Jun 28.
Yousaf A, Patterson J, Hobbs G, et al. Smoking is associated with adrenal adenomas and adrenocortical carcinomas: a nationwide multicenter analysis. Cancer Treat Res Commun. 2020;25:100206.
Last Revised: October 5, 2026
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