Multiple mutations are present in most human tumours. These genetic modifications appear to be necessary to produce and select pretumoral, tumoral and metastatic clones. These multiple mutations can be sequentially produced by genotoxic agents leading to cancers with a long latency period or due to mutations in genes implicated in the control of the genetic stability. Several human diseases are linked with a very high cancer incidence because they are hereditarily carrying a mutation on some DNA repair genes, mismatch repair genes or tumour suppressor genes. These abnormal functions will produced a mutator phenotype leading to a cascade of genetic modifications which will allow the rapid production of cancer cells.
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