Earlier this year, researchers sparked a debate after suggesting two-thirds of cancer types were down to luck rather than factors
such as smoking.
The argument has been about the relative importance of intrinsic and extrinsic factors.
The team of doctors from the Stony Brook Cancer Centre in New York who conducted a new study published in the journal Nature said "External factors play a big role, and people cannot hide behind bad luck.
"They can't smoke and say it's bad luck if they have cancer.
"It is like a revolver, intrinsic risk is one bullet.
"And if playing Russian roulette, then maybe one in six will get cancer - that's the intrinsic bad luck.
"Now, what a smoker does is add two or three more bullets to that revolver. And now, they pull the trigger.
"There is still an element of luck as not every smoker gets cancer, but they have stacked the odds against them."
Kevin McConway, a professor of applied statistics at the Open University, said: "They do provide pretty convincing evidence that
external factors play a major role in many cancers, including some of the most common.
"Even if someone is exposed to important external risk factors, of course it isn't certain that they will develop a cancer - chance is always involved.
"But this study demonstrates again that we have to look well beyond pure chance and luck to understand and protect against
cancers."
Dr Emma Smith, from Cancer Research UK, said: "While healthy habits like not smoking, keeping a healthy weight, eating a
healthy diet and cutting back on alcohol are not a guarantee against cancer, they do dramatically reduce the risk of developing the disease."
James Gallagher
Source: bbc.com
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