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. 2019 Oct 6;61(1):152–175. doi: 10.1002/em.22326

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Published 2019. This article is a U.S. Government work and is in the public domain in the USA. Environmental and Molecular Mutagenesis published by Wiley Periodicals, Inc. on behalf of Environmental Mutagen Society.

This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

PMC Copyright notice

Integrating properties of hCDMs with a field cancerization view of carcinogenesis. The coloring of “clones” is meant to represent different mutations, with pink indication mutations induced by genotoxic carcinogens and green indicating clones carrying spontaneous, preexisting mutations. Three potential avenues to carcinogenesis are depicted. Genotoxic carcinogens may induce mutations (pink) in preexisting clones carrying hCDMs (green) (1). Genotoxic carcinogens may induce genetic or epigenetic lesions in cells adjacent to pre‐existing clones hCDMs (2), with either event leading to clonal expansion of cells carrying hCDMs. Also, spontaneous tumor induction (3) may occur through interaction between mutant clones, including those carrying hCDMs (green). Expansion of clones carrying hCDMs may also be driven by exposure to non‐genotoxic carcinogens. References are Parsons 2008 and Parsons 2018b.