Although previous cohort studies on NF1 and cancer risk reported lesser associations than what we have observed in our study, they did not focus on pediatric cancer, but instead investigated cancer risk at any age28 and in individuals younger than 50 years.29 To date, only 1 Finnish study30 has evaluated the risk of pediatric cancer among children with NF1, with findings similar to ours. Here, NF1 is linked to childhood malignant neoplasm.