A stochastic model for cancer risk.

We propose a simple stochastic model based on the two successive mutations hypothesis to compute cancer risks. Assume that only stem cells are susceptible to the first mutation and that there are a total of D stem cell divisions over the lifetime of the tissue with a first mutation probability mu(1) per division. Our model predicts that cancer risk will be low if m = mu(1)D is low even in the case of very advantageous mutations. Moreover, if mu(1)D is low the mutation probability of the second mutation is practically irrelevant to the cancer risk. These results are in contrast with existing models but in agreement with a conjecture of Cairns. In the case where m is large our model predicts that the cancer risk depends crucially on whether the first mutation is advantageous or not. A disadvantageous or neutral mutation makes the risk of cancer drop dramatically.