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The paper contrasts intuitive expectations that more cell divisions should increase cancerous mutations with evidence that does not follow this pattern. Allometric scaling, a further human epidemiology observation, and evolutionary game theory are used to explain how inherited and random DNA mutations drive cancer development through successive nonclinical and clinical stages. It also discusses why prevention is more complex than avoiding environmental mutagens.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/petos-paradox-and-six-degrees-of-cancer-prevalence-abstract-and-introduction-review/326785/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/petos-paradox-and-six-degrees-of-cancer-prevalence-abstract-and-introduction-review/326785.png","ImageObject",300,407,{"name":92,"@type":93},"Logic","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is Peto’s paradox according to the paper?","Question",{"text":112,"@type":113},"Peto’s paradox refers to the lack of correlation between cancer incidence (and possibly mortality) and the number of cells across species. The paper notes that this challenges the idea that each cell has equal risk to become cancerous.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does the paper explain cancer development if more cell divisions do not straightforwardly increase risk?",{"text":117,"@type":113},"It proposes that inherited and random DNA mutations during replication nonlinearly drive cancer development. It argues that variance alone does not adequately describe tumor development and instead applies selection and evolutionary principles.",{"name":119,"@type":110,"acceptedAnswer":120},"What stages of cancer development does the paper outline?",{"text":121,"@type":113},"The paper describes sequential stages: early subclinical phases with accumulating multiple uncorrected mutations, a stage involving caretaker gene mutation and genetic instability, subsequent uncontrolled proliferation with cooperative dynamics involving stromal cells, and later a clinical phase after resetting homeostasis.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},326785,1790192291,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1099513958762,"https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1784791008015729253","cells  \nReview  \nPeto’s “Paradox” and Six Degrees of Cancer Prevalence  \nAndras Szasz   \nCitation: Szasz, A. Peto’s “Paradox”and Six Degrees of Cancer Prevalence.  \nCells 2024, 13, 197. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/cells13020197](10.3390/cells13020197)  \nAcademic Editor: Ludger Hengst  \nReceived: 24 November 2023  \nRevised: 15 January 2024  \nAccepted: 19 January 2024  \nPublished: 21 January 2024  \nCopyright: © 2024 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \nDepartment of Biotechnics, Hungarian University of Agriculture and Life Sciences, 2100 Gödöll˝o, Hungary; [biotech@gek.szie.hu](biotech@gek.szie.hu)  \nAbstract: Peto’s paradox and the epidemiologic observation of the average six degrees of tumor prevalence are studied and hypothetically solved. A simple consideration, Petho’s paradox challenges our intuitive understanding of cancer risk and prevalence. Our simple consideration is that the morea cell divides, the higher the chance of acquiring cancerous mutations, and so the larger or longerlived organisms have more cells and undergo more cell divisions over their lifetime, expecting to have a higher risk of developing cancer. Paradoxically, it is not supported by the observations. The allometric scaling of species could answer the Peto paradox. Another paradoxical human epidemiology observation in six average mutations is necessary for cancer prevalence, despite the random expectations of the tumor causes. To solve this challenge, game theory could be applied. The inherited and random DNA mutations in the replication process nonlinearly drive cancer development. The statistical variance concept does not reasonably describe tumor development. Instead, the Darwinian natural selection principle is applied. The mutations in the healthy organism’s cellular population can serve the species’ evolutionary adaptation by the selective pressure of the circumstances. Still, some cells collect multiple uncorrected mutations, adapt to the extreme stress in the stromal environment, and develop subclinical phases of cancer in the individual. This process needs extensive subsequent DNA replications to heritage and collect additional mutations, which are only marginal alone. Still, together, they are preparing for the first stage of the precancerous condition. In the second stage, when one of the caretaker genes is accidentally mutated, the caused genetic instability prepares the cell to fight for its survival and avoid apoptosis. This can be described as a competitive game. In the third stage, the precancerous cell develops uncontrolled proliferation with the damaged gatekeeper gene and forces the new game strategy with binary cooperation with stromal cells for alimentation. In the fourth stage, the starving conditions cause a game change again, starting a cooperative game, where the malignant cells cooperate and force the cooperation of the stromal host, too. In the fifth stage, the resetting of homeostasis finishes the subclinical stage, and in the fifth stage, the clinical phase starts. The prevention of the development of mutated cells is more complex than averting exposure to mutagens from the environment throughout the organism’s lifetime. Mutagenic exposure can increase the otherwise random imperfect DNA reproduction, increasing the likelihood of cancer development, but mutations exist. Toxic exposure is more challenging; it may select the tolerant cells on this particular toxic stress, so these mutations have more facility to avoid apoptosis in otherwise collected random mutational states.  \nKeywords: Peto’s paradox; mutations; six degrees of stages; evolutional game; Darwin’s law; allometry  \n1. Introdu","cbCaibN6vSfPCoxN","https://ap.wps.com/l/cbCaibN6vSfPCoxN","pdf",4154758,27,"English","# Introduction\n## Cancer as an evolutionary process\n## Peto’s paradox and cross-species comparison","[{\"question\":\"What is Peto’s paradox according to the paper?\",\"answer\":\"Peto’s paradox refers to the lack of correlation between cancer incidence (and possibly mortality) and the number of cells across species. The paper notes that this challenges the idea that each cell has equal risk to become cancerous.\"},{\"question\":\"How does the paper explain cancer development if more cell divisions do not straightforwardly increase risk?\",\"answer\":\"It proposes that inherited and random DNA mutations during replication nonlinearly drive cancer development. It argues that variance alone does not adequately describe tumor development and instead applies selection and evolutionary principles.\"},{\"question\":\"What stages of cancer development does the paper outline?\",\"answer\":\"The paper describes sequential stages: early subclinical phases with accumulating multiple uncorrected mutations, a stage involving caretaker gene mutation and genetic instability, subsequent uncontrolled proliferation with cooperative dynamics involving stromal cells, and later a clinical phase after resetting homeostasis.\"}]","Peto’s “Paradox” and Six Degrees of Cancer Prevalence - Abstract and Introduction Review | PDF",1789975342,68]