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The Two-Stage Model of Carcinogenesis

INTRODUCTION

In recent years, it has become clear that carcinogenesis is a multistep process that requires deregulation of cellular growth. Cell growth and differentiation are normally under genetic regulation, so it may be assumed that the critical events in carcinogenesis involve genetic damage and inappropriate genetic expression (Weinberg, 1988; 1989). Mathematical models based on those biologic considerations can be simple or complex depending on assumptions about the number and nature of the events required to transform normal cells into cancer cells and about the sequence of events.

The simplest model judged to be consistent with the data available—a model that assumes two critical stages—was selected for evaluation by the Committee on Risk Assessment Methodology (CRAM). The two-stage model has been proposed as an improvement over currently used models for estimating carcinogenic risks to health, because it incorporates biologic considerations, notably cell population kinetics. The principal purposes of this CRAM study were to assess the scientific basis of the two-stage model of carcinogenesis and to evaluate the possible applications of the two-stage model to health risk assessment.

As part of the information-gathering process, the committee held a workshop on November 8, 1990, with presentations by the originators and proponents of the two-stage model and by invited discussants. A



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THE TWO-STAGE MODEL OF CARCINOGENESIS 187 original typesetting files. Page breaks are true to the original; line lengths, word breaks, heading styles, and other typesetting-specific formatting, however, cannot be About this PDF file: This new digital representation of the original work has been recomposed from XML files created from the original paper book, not from the retained, and some typographic errors may have been accidentally inserted. Please use the print version of this publication as the authoritative version for attribution. The Two-Stage Model of Carcinogenesis INTRODUCTION In recent years, it has become clear that carcinogenesis is a multistep process that requires deregulation of cellular growth. Cell growth and differentiation are normally under genetic regulation, so it may be assumed that the critical events in carcinogenesis involve genetic damage and inappropriate genetic expression (Weinberg, 1988; 1989). Mathematical models based on those biologic considerations can be simple or complex depending on assumptions about the number and nature of the events required to transform normal cells into cancer cells and about the sequence of events. The simplest model judged to be consistent with the data available—a model that assumes two critical stages—was selected for evaluation by the Committee on Risk Assessment Methodology (CRAM). The two-stage model has been proposed as an improvement over currently used models for estimating carcinogenic risks to health, because it incorporates biologic considerations, notably cell population kinetics. The principal purposes of this CRAM study were to assess the scientific basis of the two-stage model of carcinogenesis and to evaluate the possible applications of the two-stage model to health risk assessment. As part of the information-gathering process, the committee held a workshop on November 8, 1990, with presentations by the originators and proponents of the two-stage model and by invited discussants. A