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Commentary: Outliving the Risk for Cancer: Novel Hypothesis or Wishful Thinking?


Hertz-Picciotto, Irva & Sonnenfeld, Nancy L. (2001). Commentary: Outliving the Risk for Cancer: Novel Hypothesis or Wishful Thinking?. Human and Ecological Risk Assessment, 7(6), 1651-7.


Early models examining the age distribution of cancer focused almost exclusively on mortality outcomes in populations ages 25 to 64 (Nordling 1953; Armitage and Doll 1954, 1957). These early studies integrated coherent observations from animal models with an understanding of epidemiological trends for specific cancer sites in order to generate testable models describing carcinogenic processes. Because diagnosis and reporting were considered to be unreliable at older ages, these papers limited their modeling to mortality data for adults under age 75. However, as early as 1969, Cook et al. noted that cancer incidence for some sites either rose more slowly at older ages or reached a peak and then declined (Cook et al. 1969). Moolgavkar, over several decades, has been developing biologically based, two-stage carcinogenesis models that incorporate cell kinetics, including tissue growth and differentiation rates (Moolgavkar and Knudson 1981), and has recently explored modifications that incorporate a decline at older ages (Moolgavkar et al. 1999). In other recent work, extensions that take into account not only cell mutation and kinetic rates, but also corrections for underreporting at older ages and population heterogeneity with regard to genetic susceptibility and environmental exposure, are predicted on achieving on age-specific maximum and a subsequent decline in cancer mortality (Herrero-Jimenez et al. 2000).


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Journal Article

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Human and Ecological Risk Assessment


Hertz-Picciotto, Irva
Sonnenfeld, Nancy L.

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