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A risk factor is anything that affects a person’s chance of getting a disease such as cancer. Different cancers have different risk factors.
Lifestyle-related risk factors such as tobacco use, diet, body weight, and physical activity play a major role in many adult cancers. But these factors usually take many years to influence cancer risk, and they are not thought to play much of a role in childhood cancers, including leukemias.
There are a few known risk factors for childhood leukemia.
Genetic risk factors are those that are part of our DNA (the substance that makes up our genes). They are often inherited from our parents. While some genetic factors increase the risk of childhood leukemia, most leukemias are not linked to any known genetic causes.
Some genetic disorders increase a child’s risk of developing leukemia:
Other genetic disorders (such as neurofibromatosis and Fanconi anemia) also carry an increased risk of leukemia, as well as some other types of cancers.
Certain inherited conditions cause children to be born with immune system problems. These include:
Along with an increased risk of getting serious infections from reduced immune defenses, these children might also have an increased risk of leukemia.
Siblings (brothers and sisters) of children with leukemia have a slightly increased chance of developing leukemia, but the overall risk is still low. The risk is much higher among identical twins. If one twin develops childhood leukemia, the other twin has about a 1 in 5 chance of getting leukemia as well. This risk is much higher if the leukemia develops in the first year of life.
Having a parent who develops leukemia as an adult does not seem to raise a child’s risk of leukemia.
Lifestyle-related risk factors for some adult cancers include smoking, being overweight, drinking too much alcohol, and getting too much sun exposure. These types of factors are important in many adult cancers, but they are unlikely to play a role in most childhood cancers.
Some studies have suggested that a woman drinking a lot of alcohol during pregnancy might increase the risk of leukemia in her child, but not all studies have found such a link.
Environmental risk factors are influences in our surroundings, such as radiation and certain chemicals, that increase the risk of getting diseases such as leukemias.
Exposure to high levels of radiation is a risk factor for childhood leukemia. Japanese atomic bomb survivors had a greatly increased risk of developing AML. If a fetus is exposed to radiation within the first months of development, there may also be an increased risk of childhood leukemia, but the extent of the risk is not clear.
The possible risks from fetal or childhood exposure to lower levels of radiation, such as from x-ray tests or CT scans, are not known for sure. Some studies have found a slight increase in risk, while others have found no increased risk. Any risk increase is likely to be small, but to be safe, most doctors recommend that pregnant women and children not get these tests unless they are absolutely needed.
Children and adults treated for other cancers with certain chemotherapy drugs have a higher risk of getting a second cancers, usually AML, later in life. Drugs such as cyclophosphamide, doxorubicin, etoposide, and teniposide have been linked to a higher risk of leukemia. These leukemias usually develop within 5 to 10 years of treatment, and they tend to be hard to treat.
Exposure to chemicals such as benzene (a solvent used in the cleaning industry and to manufacture some drugs, plastics, and dyes) may cause acute leukemia in adults and, rarely, in children. Chemical exposure is more strongly linked to an increased risk of AML than to ALL.
Several studies have found a possible link between childhood leukemia and household exposure to pesticides, either during pregnancy or early childhood. Some studies have also found a possible increased risk among mothers with workplace exposure to pesticides before their child is born. However, most of these studies had serious limitations in the way they were done. More research is needed to try to confirm these findings and to provide more specific information about the possible risks.
Children who are getting intensive treatment to suppress their immune system (mainly children who have had organ transplants) have an increased risk of certain cancers, such as lymphoma and ALL.
Other factors that have been studied for a possible link to childhood leukemia include:
So far, most studies have not found strong links between any of these factors and childhood leukemia, but researchers continue to study these exposures.
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 journalists, editors, and translators with extensive experience in medical writing.
Hargreave M, Morch LS, Andersen KK, et al. Maternal use of hormonal contraception and risk of childhood leukaemia: A nationwide, population-based cohort study. Lancet Oncol. 2018;19(10):1307-1314.
Pearce MS, Salotti JA, Little MP, et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. Lancet. 2012;380(9840):499-505.
Rabin KR, Gramatges MM, Margolin JF, Poplack DG. Chapter 19: Acute Lymphoblastic Leukemia. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia Pa: Lippincott Williams & Wilkins; 2016.
Rabin KR, Margolin JF, Kamdar KY, Poplack DG. Chapter 100: Leukemias and Lymphomas of Childhood. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.
Rock CL, Thomson C, Gansler T, et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA: A Cancer Journal for Clinicians. 2020;70(4). doi:10.3322/caac.21591. Accessed at https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21591 on June 9, 2020.
Turner MC, Wigle DT, Krewski D. Residential pesticides and childhood leukemia: A systematic review and meta-analysis. Environ Health Perspect. 2010;118(1):33-41.
Wigle DT, Turner MC, Krewski D. A systematic review and meta-analysis of childhood leukemia and parental occupational pesticide exposure. Environ Health Perspect. 2009;117(10):1505-1513.
Last Revised: June 9, 2020
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