The many causes of cancer

There are about 200 different types of cancer. It can start in any type of body tissue. What affects one body
tissue may not affect another. For example, tobacco smoke that you breathe in may help to cause lung cancer.
Oerexposing your skin to the sun could cause a melanoma on your leg. !ut the sun "on#t gie you lung
cancer and smoking "on#t gie you melanoma.
$part from infectious diseases, most illnesses %including cancer& are multifactorial. This means that there are
many factors inoled. In other "ords, there is no single cause for any one type of cancer.
Cancer causing substances (carcinogens)
$ carcinogen is something that can help to cause cancer. Tobacco smoke is a po"erful carcinogen. !ut not
eeryone "ho smokes gets lung cancer. 'o there must be other factors at "ork as "ell.
Age
(ost types of cancer become more common as "e get older. This is because the changes that make a cell
become cancerous in the first place take a long time to deelop. There hae to be a number of changes to the
genes "ithin a cell before it turns into a cancer cell. These changes can happen by accident "hen the cell is
diiding. Or they can happen because the cell has been damaged by carcinogens and the damage is then
passed on to future cells "hen that cell diides. The longer "e lie, the more time there is for genetic mistakes
to happen in our cells.
Genetic make up
There need to be a number of genetic mutations "ithin a cell before it becomes cancerous. 'ometimes a
person is born "ith one of these mutations already. This doesn#t mean they "ill definitely get cancer. !ut "ith
one mutation from the start, it makes it more likely statistically that they "ill deelop cancer during their lifetime.
)octors call this genetic predisposition.
The !*+$, and !*+$2 breast cancer genes are examples of genetic predisposition. Women "ho carry one
of these faulty genes hae a higher chance of deeloping breast cancer than "omen "ho do not.
The !*+$ genes are good examples for another reason. (ost "omen "ith breast cancer do not hae a
mutated !*+$, or !*+$2 gene. -ess than . out of ,00 breast cancers %./& are due to these genes. 'o
although "omen "ith one of these genes are indiidually more likely to get breast cancer, most breast cancer
is not caused by a high risk inherited gene fault.
This is true of other common cancers "here some people hae a genetic predisposition 0 for example, colon
%large bo"el& cancer.
*esearchers are looking at the genes of people "ith cancer in a study called '1$*+2. They also hope to find
out more about ho" other factors might interact "ith genes to increase the risk of cancer.

The immune system
3eople "ho hae problems "ith their immune systems are more likely to get some types of cancer. This group
includes people "ho
2ae had organ transplants and take drugs to suppress their immune systems to stop organ re4ection
2ae 2I5 or $I)'
$re born "ith rare medical syndromes "hich affect their immunity
The types of cancers that affect these groups of people fall into 2 oerlapping groups
+ancers that are caused by iruses, such as cerical cancer and other cancers of the genital or anal
area, some lymphomas, lier cancer and stomach cancer
-ymphomas
+hronic infections or transplanted organs can continually stimulate cells to diide. This continual cell diision
means that immune cells are more likely to deelop genetic faults and deelop into lymphomas.

Smoking, bodyweight, diet and physical activity
(any cancer cases in the 67 are linked to lifestyle factors such as smoking, alcohol, diet, or being oer"eight.
In the "estern "orld, many of us eat too much red and processed meat and not enough fresh fruit and
egetables. This type of diet is kno"n to increase the risk of cancer. )rinking alcohol can also increase the risk
of deeloping some types of cancer. There is more information about this on the page about diet causing
cancer.
'ometimes foods or food addities are blamed for directly causing cancer and described as carcinogenic. This
is often not really true. 'ometimes a food is found to contain a substance that can cause cancer but in such
small amounts that "e could neer eat enough of it to do any harm. $nd some addities may actually protect
us. There is more about food addities in the page about diet causing cancer.

ay to day environment
!y enironmental causes "e mean "hat is around you each day that may help to cause cancer. This could
include
Tobacco smoke
The sun
8atural and man made radiation
Work place ha9ards
$sbestos
'ome of these are aoidable and some aren#t. (ost are only contributing factors to causing cancers 0 part of
the 4igsa" pu99le that scientists are still trying to put together. There is more about this in the page about
causes of cancer in the enironment.

!iruses
5iruses can help to cause some cancers. !ut this does not mean that these cancers can be caught like an
infection. What happens is that the irus can cause genetic changes in cells that make them more likely to
become cancerous.
These cancers and iruses are linked
+erical cancer, and other cancers of the genital and anal area, and the human papilloma irus %235&
3rimary lier cancer and the 2epatitis ! and + iruses
-ymphomas and the 1pstein:!arr 5irus
T cell leukaemia in adults and the 2uman T cell leukaemia irus
235 may also lead to oropharyngeal cancer and non melanoma skin cancers in some people
There "ill be people "ith primary lier cancer and "ith T cell leukaemia "ho haen#t had the related irus. !ut
infection increases their risk of getting that particular cancer. With cerical cancer, scientists no" beliee that
eery "oman "ith an inasie cerical cancer has had an 235 infection beforehand.
(any people can be infected "ith a cancer causing irus, and neer get cancer. The irus only causes cancer
in certain situations. (any "omen get a high risk 235 infection, but neer deelop cerical cancer.
$nother example is 1pstein:!arr irus %1!5&. These are some facts about 1!5
It is ery common 0 most people are infected "ith 1!5
3eople "ho catch it late in life get glandular feer and hae an increased risk of lymphoma
In sub 'aharan $frica, 1!5 infection and repeated attacks of malaria together cause a cancer called
!urkitt#s lymphoma in children
In +hina, 1!5 infection %together "ith other unkno"n factors& causes nasopharyngeal cancer
In people "ith $I)s and transplant patients 1!5 can cause lymphoma
$bout ; out of ,0 cases of 2odgkin#s lymphoma %;0/& and a <uarter of cases %2=/& of !urkitt#s
lymphoma %a rare type of non 2odgkin#s lymphoma& seem to be related to 1!5 infection

"acterial infection
!acterial infections hae not been thought of as cancer causing agents in the past. !ut studies hae sho"n
that people "ho hae helicobacter pylori %2 pylori& infection of their stomach deelop inflammation of the
stomach lining, "hich increases the risk of stomach cancer. 2elicobacter pylori infection can be treated "ith a
combination of antibiotics.
*esearch is also looking at "hether substances produced by particular types of bacteria in the digestie
system can increase the risk of bo"el cancer or stomach lymphomas. 'ome researchers think that particular
bacteria may produce cancer causing substances in some people. !ut research into this issue is at an early
stage.
If bacteria do play a part in causing cancer this could be important in cancer preention. !acterial infections
can often be cured "ith antibiotics, so getting rid of the infection could be a "ay to reduce the risk of these
types of cancer.
1. Define: stimulate
2. Define: mutation
3. Define: lymphoma
4. How many types of cancers are there?
5. The longer we live the more time we have for what to happen?
!. "hat #oes genetic pre#isposition mean?
$. "hat are two genes that are e%amples of genetic pre#isposition?
&. "hy can chronic infections or transplante# organs increase your chances of getting cancer?
'. "hat type of #iet increases the chances of getting cancer?
1(. )ive e%amples of #ay to #ay environmental causes.
11. "hat #o viruses #o that may lea# to a higher chance of getting cancer?
12. *ist four viruses that are +nown to increase the ris+ for cancer an# say what +in# of cancer a
person might get for each one.
13. *ist one ,acteria that is ,elieve# to cause cancer. "hat is it a,out the ,acteria that may ,e the
reason why a person coul# get cancer with this ,acteria?