The Atlantic

No, We Can’t Say Whether Cancer Is Mostly Bad Luck

How some media outlets magnified the problems with a controversial new paper
Source: Kim Kyung Hoon / Reuters

Two years ago, Time wrongly reported that “Most cancer is beyond your control.” The Guardian incorrectly wrote: “Two-thirds of adult cancers largely ‘down to bad luck’ rather than genes.” And the BBC misleadingly said: “Most cancer types ‘just bad luck.’” All of these deceptive headlines arose from a widely misinterpreted study that looked at the role of random chance in initiating cancers. That paper was itself criticized for a slew of methodological flaws, and spawned more than a hundred rebuttals.

Its authors are now back with a follow-up, which reads like a weird blend of doubling-down, clarification, and mea culpa.  Although they’ve gone some way towards addressing the problems of their first paper, their critics still say they’ve made several of the same conceptual mistakes. And once again, their work has led to similarly botched headlines.Ultimately, this story reveals less about why people do or don’t get cancers, and more about how hard it is to talk or think about these diseases.

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In 2015, Cristian Tomasetti from Johns Hopkins Bloomberg School of Public Health and Bert Vogelstein from the Johns Hopkins Kimmel Cancer Center were trying to work out why some parts of the body, like the skin or large intestine, are so much more prone to cancer than others, like the brain or small intestine. By looking at U.S. data on 31 types of cancer, they found a clue. The lifetime risk of developing cancer in a particular tissue was strongly correlated with how often the stem cells in that tissue divide.

Which made perfect sense. When a

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