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Summary
It is a human trait to search for explanations for catastrophic events and rule out mere “chance” or “bad luck.” When it comes to human cancer, the issue of natural causes versus bad luck was raised by Tomasetti and Vogelstein about 2 years ago (1). Their study, which was widely misinterpreted as saying that most cancers are due neither to genetic inheritance nor environmental factors but simply bad luck, sparked controversy. To date, a few hundred papers have been written in response, including (2–6), with some [e.g., (2)] coming to opposite conclusions. What is this controversy about? Tomasetti and Vogelstein concluded that 65% of the differences in the risk of certain cancers is linked to stem cell divisions in the various cancerous tissues examined (1). On page 1330 of this issue, Tomasetti et al. (7) provide further evidence that this is not specific to the United States.
