“As a retired oncologist noting the well-studied risk of osteosarcoma, I agree that the continued support for this dangerous and ineffective prescription is based on money and saving face. I am appalled by the absence of informed consent when our medical culture has tried to move away from paternalistic actions.”
Nancy Crumpacker
MD, retired oncologist

Osteosarcoma is a rare type of bone cancer that begins in the cells that form bones. It occurs most often in the long bones that make up the arms and legs, although it can occur in any bone. It tends to occur in children and young adults. Symptoms include localised bone pain and swelling and treatment typically involves surgery, chemotherapy and radiation.

Osteosarcoma is one of three primary bone cancers. In 2015, 255 Australians were diagnosed with primary bone cancer. There are more than 30 different types of primary bone cancer. Also called bone sarcoma, the most common types include:

  • Osteosarcoma, which affects cells that grow bone tissue;
  • Chondrosarcoma, which grows in the cartilage;
  • Ewing’s sarcoma, which affects cells in the bone or soft tissue that multiply rapidly.
Fluoride and osteosarcoma

The timeline of research into the link between fluoridation and cancer (in particular osteosarcoma) is both complex and controversial. Although several studies have failed to detect an association between the two, it is relevant that none of these studies considered the risk of fluoride during specific ages and therefore specific growth stages in life.

In 1991, the US National Toxicology Program conducted a study finding that fluoride-treated male rats had a dose-dependent increase in osteosarcoma.18

Several human studies since then have found an association between fluoride in drinking water and the occurrence of osteosarcoma in young males.19 One particular study that did measure the risk of fluoride at specific windows in time was the Bassin study, published in 2001, which found that boys consuming fluoridated water at age 6, 7 and 8 years had a 5-fold risk of developing osteosarcoma during their teenage years. 20

A study in 201121 claimed to refute these findings, but the study’s methods — by the authors’ own admission — were incapable of assessing the age-specific risk during the window of 6 to 8 years that Bassin identified as the critical risk period from fluoride exposure.

More details are available here.

References and relevant studies

Bassin EB, Wypij D, Davis RB, Mittleman MA. (2006). Age-specific Fluoride Exposure in Drinking Water and Osteosarcoma (United States). Cancer Causes and Control 17: 421-8.

Bassin EB. (2001). Association Between Fluoride in Drinking Water During Growth and Development and the Incidence of Ostosarcoma for Children and Adolescents. Doctoral Thesis, Harvard School of Dental Medicine.

Bucher J.R., Heitmancik M.R., Toft J., Persing R.L. Eustis S.L. Haseman J.K. (1991). Results and conclusions of the National Toxicology Program’s rodent carcinogenicity studies with sodium fluoride. International Journal of Cancer 48(5):733-7.

Cohn P.D. (1992). A Brief Report On The Association Of Drinking Water Fluoridation And The Incidence of Osteosarcoma Among Young Males. New Jersey Department of Health and Environmental Health Services.

Food & Drug Administration (FDA). (1991). Dose determination and carcinogenicity studies of sodium fluoride in Crl:CD-1 Mice and Crl:CD (Sprague Dawley)BR Rats. In: Department of Health & Human Services. (U.S. DHHS) (1991). 

Review of Fluoride: Benefits and Risks. Report of the Ad Hoc Committee on Fluoride, Committee to Coordinate Environmental Health and Related Programs. Department of Health and Human Services, USA. pp. D1-D7.

Hoover R.N., Devesa S.S., Cantor K.P., Lubin J.H., Fraumeni J.F. (1991). Time trends for bone and joint cancers and osteosarcomas in the Surveillance, Epidemiology and End Results (SEER) Program. National Cancer Institute. In: Appendix E and Appendix F of, Review of Fluoride: Benefits and Risks Report of the Ad Hoc Committee on Fluoride of the Committee to Coordinate Environmental Health and Related Programs US Public Health Service.

Kim FM, et al. (2011). An assessment of bone fluoride and osteosarcoma. Journal of Dental Research 90:1171-76.

Levy M, Leclerc BS. (2012). Fluoride in drinking water and osteosarcoma incidence rates in the continental United States among children and adolescents. Cancer Epidemiology 36(2):e83-8.
Maurer JK, Cheng MC, Boysen BG, Anderson RL. (1990). Two-year carcinogenicity study of sodium fluoride in rats. Journal of the National Cancer Institute 82: 1118-26.

Maurer JK, et al. (1993). Confounded carcinogenicity study of sodium fluoride in CD-1 mice. Regulatory Toxicology and Pharmacology 18:154-68.

McGuire S.M., Douglass C.W., Joshi A., Hunter D., DaSilva J. (1995). Fluoride exposure and osteosarcoma. [Abstract] Journal of Dental Research 74:98.

Mihashi M., Tsutsui T. (1996). Clastogenic activity of sodium fluoride to rat vertebral body-derived cells in culture. Mutation Research 368:7-13.

National Academy of Sciences (1977). Drinking Water and Health. National Academy Press, Washington, DC. pp. 388-389.

National Toxicology Program [NTP] (1990). Toxicology and Carcinogenesis Studies of Sodium Fluoride in F344/N Rats and B6C3f1 Mice. Technical report Series No. 393. NIH Publ. No 91-2848. National Institute of Environmental Health Sciences, Research Triangle Park, N.C.
World Health Organization (2002). Environmental Health Criteria 227: FLUORIDES. World Health Organization, Geneva.

Yiamouyiannis J. (1993). Fluoridation and Cancer: The Biology and Epidemiology of Bone and Oral Cancer Related to Fluoridation. Fluoride 26: 83-96.