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Selection presupposes competition among clones\u2014that is, survival advantage of the mutated species; without selective forces a mutation is mute, while the lack of mutations makes selective advantage impossible. The identification of carcinogen related fingerprints is ambiguous: it can suggest both a genuine mutational hotspot left by the carcinogenic stimulus (like in tobacco related <jats:italic>p53<\/jats:italic> mutations), and selective advantage of clones whose mutations seem to be not exposure specific (like in the case of aflatoxin). We present several examples of exposures that can increase the risk of cancer in humans not <jats:italic>via<\/jats:italic> mutations but through a putative mechanism of clone selection.<\/jats:p>","DOI":"10.1136\/jech.57.2.89","type":"journal-article","created":{"date-parts":[[2003,1,22]],"date-time":"2003-01-22T17:10:54Z","timestamp":1043255454000},"page":"89-95","source":"Crossref","is-referenced-by-count":17,"title":["An evolutionary paradigm for carcinogenesis?"],"prefix":"10.1136","volume":"57","author":[{"given":"P","family":"Vineis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Matullo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Manuguerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2003,2,1]]},"reference":[{"key":"2025100301511342000_57.2.89.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04136-2"},{"key":"2025100301511342000_57.2.89.2","doi-asserted-by":"publisher","DOI":"10.1038\/nbt0397-194"},{"key":"2025100301511342000_57.2.89.3","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S1383-5742(98)00028-3","volume":"436","year":"1999","journal-title":"Mutation Res"},{"key":"2025100301511342000_57.2.89.4","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1353\/pbm.1974.0049","volume":"17","year":"1974","journal-title":"Perspect Biol Med"},{"key":"2025100301511342000_57.2.89.5","doi-asserted-by":"publisher","DOI":"10.1038\/206480a0"},{"key":"2025100301511342000_57.2.89.6","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/j.1749-6632.2000.tb06870.x","volume":"919","year":"2000","journal-title":"Ann N Y Acad Sci"},{"key":"2025100301511342000_57.2.89.7","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1202214"},{"key":"2025100301511342000_57.2.89.8","doi-asserted-by":"publisher","DOI":"10.1126\/science.274.5286.430"},{"key":"2025100301511342000_57.2.89.9","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.180320897"},{"key":"2025100301511342000_57.2.89.10","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/22.3.367"},{"key":"2025100301511342000_57.2.89.11","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.93.24.14025"},{"key":"2025100301511342000_57.2.89.12","doi-asserted-by":"publisher","DOI":"10.1093\/carcin\/12.3.493"},{"key":"2025100301511342000_57.2.89.13","unstructured":"International Agency for Research on Cancer. 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