Cancer — Nature, Nurture, or Both

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Abstract
The relative roles of genetic constitution and environmental exposure in the causation of cancer have been debated for decades.1 Geographic differences, trends over time in the risk of cancer, and detailed studies of migrant populations overwhelmingly implicate environmental exposures as major causal factors and often identify the responsible carcinogens (e.g., tobacco, alcohol, radiation, occupational toxins, infections, diet, drugs). From this work has come the widely accepted estimate that 80 to 90 percent of human cancer is due to environmental factors.2 Yet in the past 15 years, the explosion of molecular genetics has overshadowed environmental explanations by revealing genetic mechanisms underlying . . .