Once again we are nearing the end of the year, and here at the Scottish Cancer Prevention Network, we’ve invited our members, colleagues and regular SCPN Newsletter contributors to recommend what they have been reading on cancer prevention during 2016. We’ve asked each of them to recommend one paper which they thought would be valuable to share. Next in our series of Papers of the Year 2016. This paper got top marks from Dr David Brewster, Director of the Scottish Cancer registry, Information services Division, NHS National services Scotland



Title: Substantial contribution of extrinsic risk factors to cancer development.

Authors: Wu S, Powers S, Zhu W, Hannun YA.

Weblink: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836858/pdf/nihms733229.pdf

Why is this paper important?

In 2015, a widely reported article in Science (Tomasetti C, Vogelstein B. Variation in cancer risk among tissues can be explained by the number of stem cell divisions. Science 2015;347:78-81) proposed that “bad luck” explains a far greater number of cancers than hereditary and environmental factors. For epidemiologists, this was difficult to reconcile with the observation of very large differences in cancer incidence in different populations, coupled with the findings of migrant studies, not to mention numerous epidemiological studies identifying environmental risk factors for cancer. The “bad luck” hypothesis was challenged in an article by Wu et al in Nature, published in January 2016. They concluded that intrinsic risk factors contribute only modestly to cancer development, and that cancer risk is heavily influenced by extrinsic factors.

Main take home messages

Public communication of science poses significant challenges.

A substantial proportion of cancers are probably not simply inevitable and due only to “bad luck”.

Primary prevention remains a crucially important part of any rational cancer control strategy.


We’ll be sharing Papers of the Year throughout December – keep an eye out on our Twitter feed for more updates. Each of the papers will be available here as they are posted.