ArticleJournal of the National Cancer Institute2015
Is bad luck the main cause of cancer?
Article in Journal of the National Cancer Institute, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed.
- Cancer Prevalence across Vertebrates.Cancer discovery · 2025Article
- Latent Archetypes of the Spatial Patterns of Cancer.Statistics in medicine · 2024Article
- Cancer Prevalence Across Vertebrates.Research square · 2023Article
- The role of chance in cancer causation.La Medicina del lavoro · 2022Article
- Quantifying substantial carcinogenesis of genetic and environmental factors from measurement error in the number of stem cell divisions.BMC cancer · 2022Article
- Determining cancer risk: the evolutionary multistage model or total stem cell divisions?Proceedings. Biological sciences · 2020Article
- Pivoting from decomposing correlates to developing solutions: An evidence-based agenda to address drivers of health.Health services research · 2020Article
- Commonly used estimates of the genetic contribution to disease are subject to the same fallacies as bad luck estimates.European journal of epidemiology · 2019Review
- Flaxseed Lignans as Important Dietary Polyphenols for Cancer Prevention and Treatment: Chemistry, Pharmacokinetics, and Molecular Targets.Pharmaceuticals (Basel, Switzerland) · 2019Review
- Stem cell replication, somatic mutations and role of randomness in the development of cancer.European journal of epidemiology · 2019Review
- Case Studies of Gastric, Lung, and Oral Cancer Connect Etiologic Agent Prevalence to Cancer Incidence.Cancer research · 2018Article
- Inequality in genetic cancer risk suggests bad genes rather than bad luck.Nature communications · 2017Article
- Mathematical Modeling Links Pregnancy-Associated Changes and Breast Cancer Risk.Cancer research · 2017Article
- Health Equity and the Fallacy of Treating Causes of Population Health as if They Sum to 100.American journal of public health · 2017Article
- Area-Level Poverty and Excess Hospital Readmission Ratios.The American journal of medicine · 2017Article
- The Obesity-Breast Cancer Conundrum: An Analysis of the Issues.International journal of molecular sciences · 2016Review
- Mutation and Human Exceptionalism: Our Future Genetic Load.Genetics · 2016Article
- Cancer Prevention: Obstacles, Challenges and the Road Ahead.Journal of the National Cancer Institute · 2016Review
- Birth Month and Cardiovascular Disease Risk Association: Is meaningfulness in the eye of the beholder?Online journal of public health informatics · 2016Article
- Strategies to Prevent "Bad Luck" in Cancer.Journal of the National Cancer Institute · 2015Article
Corrections and comments
- Commented on by
- Commented on byResponse.2015
Authors and funding
2 authors.
Funding
Abstract
A recent study reports that the log lifetime incidence rate across a selection of 31 cancer types is highly correlated with the log of the estimated tissue-specific lifetime number of stem cell divisions. This observation, which underscores the importance of errors in DNA replication, has been viewed as implying that most cancers arise through unavoidable bad luck, leading to the suggestion that research efforts should focus on early detection, rather than etiology or prevention. We argue that three statistical issues can, if ignored, lead analysts to incorrect conclusions. Statistics for traffic fatalities across the United States provide an example to demonstrate those inferential pitfalls. While the contribution of random cellular events to disease is often underappreciated, the role of chance is necessarily difficult to quantify. The conclusion that most cases of cancer are fundamentally unpreventable because they are the result of chance is unwarranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.