Evolution and the inevitability of human cancer.

Natural selection, which is absolutely dependent on genetic differences between individuals, is the process by which life has evolved on this planet. Genetic variability is ultimately depended on the occurrence of new mutations in the germ-line of species. The rate at which this occurs appears not to be arbitrary or dependent on chance external events. Rather the available evidence suggests that it is highly controlled and determined by endogenous processes. However, the body does not have separate mechanisms for controlling mutation frequency in the germinal and somatic lineages and the selective process described inevitably has also led to somatic cells being subject to mutation accumulation. Indeed, since mutation frequency increases exponentially with time, the human somatic mutation frequency at approximately 80 years of age in epithelial tissues appears to be more than 10-fold higher than in the human germline. This normal but highly elevated somatic mutation frequency is sufficient to account for the complex multi-step process of human tumorigenesis even in the absence of the effects of major external mutagens or rare transitions to even more elevated mutation frequencies. Thus, scrutiny of the apparently disparate biological phenomena of evolution and tumorigenesis leads to the postulate that they are in fact two interdependent manifestations of the same underlying process and that given an evolutionary process dependent on mutation accumulation then cancer in long lived organisms is an inevitable consequence. Copyright 1998 Academic Press.