Authors: Frédéric Thomas, Randolph M. Nesse, Robert Gatenby, Cindy Gidoin, François Renaud, Benjamin Roche, Beata Ujvari
Brief summary of the paper: There is striking variation in the incidence of cancer in human organs. Malignant tumors are common in the colon and breast but rare in the heart and small bowel. The uterus frequently develops benign fibroid tumors but uterine cancers are relatively rare. The organ-specific difference in cancer prevalence has been explained primarily by the relative roles of intrinsic and extrinsic risk factors.
In this opinion article, we propose also considering organs as distinct but connected ecosystems whose different vulnerabilities to malignant transformation may be partially explained by how essential each organ is for survival through the age of reproduction. We present and discuss some of the basic concepts and assumptions of this perspective on evolutionary medicine.
Despite extensive research, we lack a full explanation for why certain tissues exhibit more susceptibility to cancer than others. An approach focusing on the evolutionary ecology of organs could provide intriguing insights that transcend the dichotomist search for intrinsic versus extrinsic risk factors.
Organs in which malignant cells emerge, survive, and proliferate can be viewed as specialized islands in a living landscape, each with its own distinct ecologies.
All organs serve the organism as a whole, but they differ in how crucial they are to survival and reproduction.
Selection for cancer suppression should be stronger for organs that are more essential for the host’s survival and Darwinian fitness.
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