Growth spurts may trigger bone cancers in teenagers, researchers suggest.
Teenagers are a 'forgotten tribe' in cancer care, experts say
University of Manchester research presented to the Teenage Cancer Trust conference looked at 1.6m cases of cancer in people up to the age of 79.
They found bone cancers and certain types of ovarian and testicular cancers hit adolescents and young adults hardest.
The researchers suggest puberty and infections could also prompt tumours to develop in susceptible individuals.
Teenage cancer patients are rare - they account for just 1% of all cancer cases. But it is the second largest cause of death in that age group after accidents.
Researchers looked at cancer incidence in the UK from 1995 to 2003.
Over that time, 14,000 were diagnosed in people aged from 13 to 24.
Incidence of specific forms of the disease were found to peak in this age group.
- Osteosarcoma and Ewing sarcoma - both kinds of bone tumours
- Germ cell (reproductive cell) tumours in the testicles, ovary and brain
- Hodgkin's lymphoma - a cancer of the lymph nodes
- Some rare soft tissue cancers
These tumours represent a third of all cancers in 13 to 24-year-olds.
Three quarters of osteosarcomas occur in the long bones of the legs, and another 10% in the arms.
The researchers suggest pre-cancerous genetic changes occur in the bone tissue during childhood and that during periods of rapid growth in teenagers further genetic damage occurs, turning these cells cancerous.
A similar pattern is also seen for Ewing sarcoma, which they said may be caused by related factors.
Incidence of testicular cancer, which is usually a germ cell cancer whatever the age of the patient, is known to peak in young adults.
In contrast, ovarian cancers tend to peak in the over-60s. However, the Manchester team's research showed germ cell tumours of the ovary are most frequent in older teenagers.
Germ cell tumours in the brain also disproportionately affect this age group.
Hormonal and other factors affecting growth and development before and after birth could affect their development, the researchers said.
The Epstein-Barr virus has already been suggested as a cause for Hodgkin lymphoma, but the researchers suggest other infectious agents may also cause the cancer.
Professor Jillian Birch, Cancer Research UK Professorial Fellow at the University of Manchester led the study.
She said: "These can be regarded as 'true' teenage and young adult cancers that typically occur specifically in this age group.
"Having identified the very specific types that are teenage and young adult cancers, we are able to find clues as to why this age group gets cancer.
"These point to infections, adolescent growth spurts, hormones and other growth and development factors as among the most probable causes."
Experts said exposure to chemicals during development in the womb and childhood was one potential cause that was also being considered by researchers.
Professor Tim Eden, appointed as the UK's first professor of teenage cancer by the Teenage Cancer Trust, said: "These patients might be very susceptible to something which might be safe for the rest of the population."
Researchers are particularly interested to see if exposure to tobacco smoke, either through their own or passive smoking, could increase the risk of cancers in the young, though not necessarily lung tumours.