Multistep carcinogenesis: a 1992 perspective.

Cancer is the leading cause of death in Japan. Recent changes in cancer incidence patterns may reflect the trend toward a more Western diet and life-style. Among the dietary factors that contribute to carcinogenesis are the heterocyclic amines, a group of mutagenic compounds present in cooked meat and fish. Carcinogenesis is a multistep process in which cells accumulate multiple genetic alterations as they progress to a more malignant phenotype. Recognition of the growing number of interacting factors that contribute to carcinogenesis may force reconsideration of current methods of risk assessment.