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Pediatric brain tumors are the second most common cancer of childhood. While it is unclear why most brain tumors form, exposure to radiation and inheritance of genetic mutations have been found to correlate with an increased risk of brain tumors.

Pediatric brain tumors are the second most common cancer of childhood. It is important to recognize the symptoms and signs of brain tumors in children, as well the risk factors associated with the development of these tumors [1].

While it is unclear why most brain tumors form, there are certain things, known as risk factors, that can increase the chances of getting this disease.

Cancer in adults can be influenced by a range of lifestyle-associated risk factors including obesity, sedentary lifestyle and smoking, however, these factors are not associated with the formation of childhood cancers. In fact, there are only a few risk factors that are known to cause childhood brain tumors including:

  • radiation exposure and
  • genetics [2].

Radiation Exposure

One of the most well-known risk factors associated with the development of brain tumors is radiation exposure to the brain. Radiation was previously used to treat ringworm of the scalp, which is a fungal infection, however, as children that underwent radiation grew older, some of them developed brain tumors.

Currently, brain tumors that form due to radiation generally occur in children treated for other types of cancers such as leukemia [3]. If these children do develop brain tumors, it is likely around 10-15 years post-radiation therapy.

However, the risk of developing a brain tumor due to radiation is fairly small, and therefore, the benefits of receiving radiation therapy outweigh the associated risks. Despite this, physicians only administered radiation after carefully weighing the options and try to minimize all risk.

Another route through which radiation exposure can occur in children is through the use of imaging tests such as x-rays or CT scans, which emit low levels of radiation[4]. However, since the levels are much lower than radiation therapy, chances of developing a brain tumor are very small. Nonetheless, doctors recommend that pregnant women and children don’t undergo these imaging tests.

Genetics

In 5% of cases, brain tumors can form if children inherit certain genes from parents or due to mutations that occur in genes prior to birth.

One of the most commonly mutated genes that is associated with pediatric brain tumors is called neurofibromatosis type 1 (NF1). While generally inherited, it can also occur in children with no prior family history. The tumors that arise due to this disease are: 

  • optic gliomas,
  • other brain gliomas or neurofibromas, which are benign tumors of peripheral nerves.

Another disease associated with pediatric brain tumors is neurofibromatosis type 2, which may or may not be inherited. This occurs due to mutations in the gene NF2, and has been found to be associated with: 

  • schwannomas,
  • meningiomas,
  • spinal cord gliomas and
  • ependymomas [5].

Another gene associated with a risk of developing certain tumors is the gene TSC1 or TSC2, both of which cause the development of the disease tuberous sclerosis. Children with mutations in these genes have a higher chance of developing subependymal giant cell astrocytomas and other types of benign tumors.

Mutations in the VHL gene lead to the Von Hippel-Lindau disease, however, they also can contribute to the formation of blood vessel tumors such as hemangioblastomas of the cerebellum, spinal cord or retina [6].

TP53 is an important tumor suppressor gene and mutations in this gene has been associated with a range of tumors which are not just restricted to the brain. TP53 mutations have led to an increased risk of gliomas of the brain.

Other diseases that may be associated with the formation of certain brain tumors are: 

  • Gorlin syndrome,
  • Turcot syndrome,
  • Cowden syndrome,
  • hereditary retinoblastoma and
  • Rubinstein-Taybi syndrome.

Furthermore, there are mutations that can be specific to a certain family or are not well-characterized [7].

Other factors

There are some risk factors that are thought to contribute to tumor formation but there have been no definite studies that have established a link.

One of the most controversial reasons thought to play a role is the use of cell phones.

Cell phones emit radiofrequency rays, which are a type of electromagnetic waves. While cell phones do not emit ionizing radiation, which can actually cause DNA damage and thus, cancer, cell phones do have an antenna that emits radiofrequency arrays.

As cell phones are placed right next to people’s heads, it may increase a risk for brain tumors.

While some people have suggested an increased risk for brain tumors, particularly schwannoms in adults that frequently use cell phones, most long-term and large-scale studies have failed to find an increased risk [8].

However, since cell phones have not been around for a long time, there is no way to truly knowing the long-term risks of using cell phones regularly. Furthermore, cell phone technology has changed drastically since they were introduced and that could also skew results. Risks associated with cell phone use are constantly being studied but it can be a long time before any obvious risk can be assessed.

Until then, it is recommended for children to use the speaker function or headphones for communication [9].

Other things that have been suggested as potentially contributing to the development of brain tumors are exposure to aspartame, which is often used as a sugar substitute. Furthermore, exposure to electromagenetic fields, such as exposure to power lines and transformers and infection by viruses are all suggested to be possible risk factors. However, most studies have not found a link between any of these factors and an outcome of brain tumors but these studies require long-term monitoring and therefore continue to be explored [10].

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