Fig. 1: In continuous competition for the basal layer in stratified esophageal epithelium, micro-tumors (grey) interface with wild-type (orange, disadvantaged) and other mutant (green, selectively advantaged) clones.

Micro-tumors that collide with the latter cells get extruded from the epithelium. Only lesions that survive this competition and accumulate additional mutations form invasive cancers. Graphics generated in Biorender.