The relationship between total stem-cell divisions and lifetime cancer risk is complicated by variation in the number of mutational hits (M) predicted to be required to initiate a given cancer. The estimated value of M was calculated for each cancer and shown by the different symbols. Two pairs (FAP C versus C, and FAP D versus D) are comparisons of familial and non-familial colorectal (C) and duodenal (D) adenocarcinoma discussed in the text. Data are from Tomasetti & Vogelstein [28], and the cancers represented are: 1–5, osteosarcoma (pelvis, head, arms, legs and overall); 6, ovarian germ cell cancer; 7, thyroid medullary carcinoma; 8, medulloblastoma; 9, glioblastoma; 10, gallbladder adenocarcinoma; 11, thyroid follicular carcinoma; 12 and 13, lung adenocarcinoma (non-smokers, smokers); 14 and 15, hepatocellular carcinoma (hepatitis C virus, normal); 16, pancreatic ductal adenocarcinoma; 17, melanoma; 18, testicular germ cell cancer; 19, oesophageal squamous cell carcinoma; 20, pancreatic endocrine (islet cell) carcinoma; 21, basal cell carcinoma; 22 and 23, leukaemia (chronic lymphocytic, acute myeloid); 24 and 25, head and neck squamous cell carcinoma (no human papilloma virus, HPV); 26 and 27, duodenal adenocarcinoma (FAP, normal); 28–30, colorectal adenocarcinoma (FAP, normal, Lynch syndrome); 31, small intestinal adenocarcinoma.