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Epidemiology

Age distribution and a multi-stage theory of carcinogenesis: 70 years on

British Journal of Cancer volume 128, pages 404–406 (2023)Cite this article

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Abstract

The Armitage Doll model demonstrates that the impact of age-dependent exposure to carcinogenic factors depends on whether the induced change occurs early, at the midpoint or late in carcinogenesis. 70 years on, updated modelling shows that their epidemiological observations still provide insight into clinical observations and their underlying molecular mechanisms.

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Fig. 1: Change in incidence and mortality for a selection of cancers between Armitage and Doll publication and the modern era.

Data availability

The UK cancer registration statistics used in the commentary are publically available at the websites as referenced.

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Acknowledgements

This study represents independent research supported by the National Institute for Health and Care Research (NIHR) Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. AW acknowledges funding from the RMH/ICR Cancer Research UK RadNet Centre.

Author information

Authors and Affiliations

  1. Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK

    Anna Wilkins

  2. The Royal Marsden Hospitals NHS Trust, London, UK

    Anna Wilkins & Rosalind Eeles

  3. Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK

    Richard Corbett

  4. Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK

    Rosalind Eeles

Authors
  1. Anna Wilkins
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  2. Richard Corbett
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  3. Rosalind Eeles
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Contributions

AW, RC and RE planned the commentary. AW and RC drafted the original manuscript and RE reviewed and edited the manuscript. All authors agreed to submission of the final version.

Corresponding author

Correspondence to Anna Wilkins.

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The authors declare no competing interests.

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All analysis in this manuscript is on UK publically-available data as referenced.

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Wilkins, A., Corbett, R. & Eeles, R. Age distribution and a multi-stage theory of carcinogenesis: 70 years on. Br J Cancer 128, 404–406 (2023). https://doi.org/10.1038/s41416-022-02009-9

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  • DOI: https://doi.org/10.1038/s41416-022-02009-9

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