Does luck play a role in cancer risk? A recent paper published in Science suggests this may be the case. Study researchers Drs. Tomasetti and Vogelstein of Johns Hopkins University concluded that up to two thirds of cancer could be attributed to “bad luck” – random genetic mutations that arise from the division of otherwise healthy stem cells.

With the assertion that only one third of cancers are attributable to hereditary and environmental factors, the article challenges the very notion that prevention is key to reduction of cancer rates. Not surprisingly, this claim has sparked spirited debate within the health field.

In a press release rebutting the authors’ conclusions, Dr. Christopher Wild, the Director of the WHO’s International Agency for Research on Cancer, said, “We already knew that for an individual to develop a certain cancer there is an element of chance, yet this has little to say about the level of cancer risk in a population.  Concluding that ‘bad luck’ is the major cause of cancer would be misleading and may detract from efforts to identify the causes of the disease and effectively prevent it.” 

At Health Care Without Harm, we work with partner hospitals to reduce exposures to carcinogens and address environmental contributors to disease. According to the study, dangerous chemicals and proven environmental carcinogens have very little bearing on the actual risk of developing cancer. 

HCWH Science Advisor Ted Schettler weighed in on the debate in his blog for the Science and Environmental Health Network, noting that the authors of the study do not explore environmental impacts on DNA during stem cell division, such as chemical mutagens or radiation. Additionally, investigators only quickly touch on the possibility that environmental effects and genetics may influence stem cell counts and their multiplication rate.

Stating that the data presented in the study is not sufficient to support the theory that cancer is primarily due to “bad luck,” Schettler concluded, “Cancer trends in specific tissues over decades make clear that environmental factors are deeply involved. By drawing conclusions that go beyond their data, the authors may deflect attention from the critical need to expand public health cancer prevention programs in our homes, communities, and workplaces. That would truly be an unfortunate outcome.”