Table 1 Comparison of the key features of the conventional and ‘etiologic field effect’ models
Conventional field effect model | ‘Etiologic field effect’ model |
|---|---|
Defined by presence of aberrant cellular and/or molecular changes | Defined by presence of etiologic exposures and their influence on tissue microenvironment |
Markers are usually neoplasia-associated molecular changes observed within the target tissue | Markers may not, in themselves, be markers of neoplastic cells, and may indicate microenvironmental changes. Markers may be systemic, or detected at surrogate sites. |
Implies a territory of altered premalignant or preneoplastic cells, which are typically epithelial cells | Embraces the potential contribution of non-transformed cells and extracellular matrices to neoplastic evolution |
Focuses on associations between molecular aberrations and cancer occurrence | Focuses on interactions between diverse etiologic exposures and tumor initiation, evolution and progression, up to patient death |
Typically pertains to contiguous anatomic structures | Not restricted by anatomic boundaries and may involve multiple anatomic sites |
Implies a territory with defined borders | May be represented by a continuum of variation in microenvironmental change |
Limited to initiating phases of neoplasia | Encompasses all phases of neoplastic evolution |
