Evaluating intrinsic and non-intrinsic cancer risk factors

Abstract

Discriminating the contribution of unmodifiable random intrinsic DNA replication errors (‘bad luck’) to cancer development from those of other factors is critical for understanding cancer in humans and for directing public resources aimed at reducing the burden of cancer. Here, we review and highlight the evidence that demonstrates cancer causation is multifactorial, and provide several important examples where modification of risk factors has achieved cancer prevention. Furthermore, we stress the need and opportunities to advance understanding of cancer aetiology through integration of interaction effects between risk factors when estimating the contribution of individual and joint factors to cancer burden in a population. We posit that non-intrinsic factors drive most cancer risk, and stress the need for cancer prevention.

Abstract

Understanding the contributions of extrinsic and intrinsic factors on cancer risk is fundamental in determining the intervention and prevention strategies to tackle cancer. Here the authors provide a review of the different factors impacting cancer risk and discuss the limitations of different approaches in evaluating the relative contributions of these factors.