Saunders examines whether cancer is either largely bad luck or almost entirely preventable. US researchers aimed to resolve conflicting evidence by using genome-wide sequencing and population-wide disease data from 69 countries. The study show that the link between stem cell divisions and cancer holds across nations with very different environmental conditions. The authors used a model that could distinguish between internal and external drivers of mutation in a more complete way. This goes some way to resolving apparent conflict between biological mechanisms and population-level estimates of the role of environmental factors. Unsurprisingly, the answer lies somewhere in the middle. Two key messages emerge. First, it is impossible to say with certainty what caused a particular tumor, so trying to translate population-wide data to individual cases is not wise. Second, people can reduce cancer risk by modifying lifestyle, but chance does play a significant role
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