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These abnormalities are responsible for the presence of multilocular clinical and sub-clinical cancerous lesions that explains the increased risks of multiple cancers in this area.
The field cancerization effect, which is associated with an increased risk of multiple cancers in aerodigestive organs after prolonged exposure to cigarette smoking, is a well-known example of this phenomenon [ 20].
Fourteen years after he sounded the alarm, Dr Jawad Al-Ali reports "phenomenal" multiple cancers in entire families.
However, with Australia's ageing population leading to increasing rates of multiple cancers in the future (in 2015 it was estimated that the risk of being diagnosed with cancer by the age of 85 is one in two for Australian men and one in three for Australian women), hopefully metal-based anticancer drugs will be given the funding and recognition they deserve.
Hypertension was also associated with an increased risk of multiple cancers in men and women in this cohort (27).
Similarly, low-frequency mutations in DDHD1, HNF1A and CHEK2 within endometrial cancer samples were shown to be highly mutated sites/regions in multiple cancers in the COSMIC database.
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None of these patients underwent endoscopic mucosal resection, preoperative chemotherapy or radiotherapy, or had metachronous multiple cancer in other organs.
Numerous cell division related proteins, which are highly expressed in multiple cancers, are involved in the initiation of CIN in cancer cells [ 8, 9].
In his commentary, Ian Cree [ 5] discusses how technical improvements in tests to detect circulating tumor markers, and indeed the potential for some molecules to act as general tumor markers, raise the possibility of blood test-based general screening for multiple cancers - in effect, screening for who to screen.
PTEN is a candidate tumour suppressor gene and frequently mutated in multiple cancers, however, not in pancreatic cancer.
This table can be used to quickly identify genes that are differentially expressed in multiple cancer types in one or more patients.
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