In 2015, Tomasetti and Vogelstein published a paper in Science containing the following provocative statement: “… only a third of the variation in cancer risk among tissues is attributable to environmental factors or inherited predispositions. The majority is due to “bad luck,” that is, random mutations arising during DNA replication in normal, noncancerous stem cells.” The paper—and perhaps especially this rather coy reference to “bad luck”—became a flash point for a series of letters and reviews, followed by replies and yet further counterpoints. In this paper, I critically assess Tomasetti and Vogelstein's argument, discuss the meaning of “luck” (or, better: “chance”) in the context of the debate, and use this case study to address larger questions about methodological criteria for causal explanations of population level patterns in biomedicine.

中文翻译：

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癌症是运气问题吗？

2015 年，Tomasetti 和 Vogelstein 在 Science 上发表了一篇论文，其中包含以下挑衅性声明：“……组织中癌症风险的变化中，只有三分之一可归因于环境因素或遗传倾向。大多数是由于“运气不好”，即正常非癌干细胞在 DNA 复制过程中出现的随机突变。” 这篇论文——也许尤其是这种对“运气不好”的相当腼腆的提及——成为了一系列信件和评论的引爆点，随后是回复和进一步的反驳。在这篇论文中，我批判性地评估了 Tomasetti 和 Vogelstein 的论点，在辩论的背景下讨论了“运气”（或者，更好的是：“机会”）的含义，