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An evolutionary perspective on field cancerization.

Kit Curtius1, Nicholas A Wright1, Trevor A Graham1

  • 1Centre for Tumour Biology, Barts Cancer Institute, EC1M 6BQ London, UK.

Nature Reviews. Cancer
|December 9, 2017
PubMed
Summary
This summary is machine-generated.

Field cancerization, the presence of pre-malignant cells without visible changes, underlies many common cancers. Measuring this field can improve cancer risk prediction for patients with pre-malignant conditions.

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Area of Science:

  • Oncology
  • Cancer Biology
  • Evolutionary Medicine

Background:

  • Tumorigenesis initiates before detectable lesions or morphological changes.
  • Field cancerization, characterized by a normal-appearing but pre-primed cell population, is implicated in common cancers like lung, colon, skin, prostate, and bladder.
  • This phenomenon results from somatic cell evolution, where cells acquire some, but not all, malignant phenotypes.

Purpose of the Study:

  • To review evidence of field cancerization across various organs.
  • To examine the biological mechanisms driving field creation.
  • To discuss clinical implications for cancer risk prediction.

Main Methods:

  • Literature review of field cancerization evidence.
  • Analysis of biological mechanisms underlying somatic cell evolution in cancer.
  • Discussion of clinical applications for risk stratification.

Main Results:

  • Field cancerization is a recognized mechanism in multiple common cancer types.
  • Somatic evolution of cells leads to the development of cancerized fields.
  • Measurements of the cancerized field hold potential for improved risk prediction.

Conclusions:

  • Field cancerization is a critical, early stage in tumorigenesis.
  • Understanding the evolutionary mechanisms of field creation is key.
  • Quantifying the cancerized field may enhance clinical cancer risk assessment.