Age distribution and a multi-stage theory of carcinogenesis: 70 years on

The Armitage Doll model demonstrates that the impact of age-dependent exposure to carcinogenic factors depends on whether the induced change occurs early, at the midpoint or late in

carcinogenesis. 70 years on, updated modelling shows that their epidemiological observations still provide insight into clinical observations and their underlying molecular mechanisms.

The UK cancer registration statistics used in the commentary are publically available at the websites as referenced.

This study represents independent research supported by the National Institute for Health and Care Research (NIHR) Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and

the Institute of Cancer Research, London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. AW acknowledges

funding from the RMH/ICR Cancer Research UK RadNet Centre.

Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK

Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK

Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK

AW, RC and RE planned the commentary. AW and RC drafted the original manuscript and RE reviewed and edited the manuscript. All authors agreed to submission of the final version.

All analysis in this manuscript is on UK publically-available data as referenced.

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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