Cancer happens for a lot of reasons. It happens because cells in the body evolve to proliferate out of control. It happens because our evolved cancer suppression systems aren’t perfect. And it happens because many of the exposures we have in our modern world – like sun, smoking and even too many calories – overwhelm our body’s ability to suppress cancer.

Our cancer suppression mechanisms evolved for a world that is not the world we live in today. This mismatch between our ancestral environment (in which our cancer suppression systems evolved) and the current environment that we live in is part of why we get cancer. It is not the whole story – there are other important factors like tradeoffs,1 constraints,2 and the inevitability of evolution among cells in the body3 – but modern exposures are an important part of the story as well. They don’t explain why we are susceptible to cancer in the first place (it’s because we are multicellular,4 in case you’re wondering), but modern exposures are part of the reason why rates of some cancers – like skin, lung, breast and gastrointestinal cancers – are particularly high.

If you have very light skin, it’s likely that your ancestors came from northern latitudes where there was little sun exposure. We need a certain amount of sun exposure for our bodies to function normally – to synthesize vitamin D and other important nutrients – and so populations that lived in northern latitudes evolved light skin that allowed sun in. Light-skinned individuals who live in or visit areas that are close to the equator are at higher risk for skin cancer5 because their skin lets in more radiation from the sun that can damage DNA and spur on cellular evolution in the body that can eventually result in cancer.

Smoking is another modern exposure that increases cancer risk. Smoking increases cancer risk because the smoke contains chemical carcinogens that can damage DNA, leading to more mutations. There are other chemical carcinogens in our modern world that contribute to cancer: asbestos, arsenic, some flame-retardants, waste from some manufacturing processes.6 But smoking is the big contributor of the chemical carcinogens – heavy smoking increases cancer risk by about 4 – 40 times.7

We eat much more and exercise much less than our ancestors ever did. This means that we have a huge amount of excess calories that our bodies have to store and manage. When we have higher body fat, this alters our physiology. It raises our hormone levels, alters our metabolism and insulin regulation and can increase inflammation. All of these processes can contribute to increased cancer risk. Eating lots of meat8 and simple carbohydrates9 is associated with increased risk of cancer and regular exercise is associated with lower cancer risk.10

Modern reproductive patterns also contribute to breast cancer risk. In hunter-gatherer populations women typically start having children around age 18, have 5 children and wean them around age 3.11 This is very different from modern populations where women typically start having children at age 26, have an average of 1.86 children and typically wean them before 6 months of age.12 Our ancestors probably had reproductive patterns similar to modern-day hunter gatherers and therefore had far fewer menstrual cycles than we modern humans have. Modern reproductive patterns like these are associated with higher risk of hormone positive breast cancers.13

Another modern exposure that may contribute to cancer risk is – somewhat ironically – lower exposure to infectious diseases during childhood. If the immune system doesn’t get the stimulation from diverse microbes in the first years of life, it can end up overreacting when it does encounter an infectious agent; sometimes with devastating consequences including childhood leukemia. Studies from around the world have found that day care attendance in infancy (which is considered a good proxy for infectious disease exposure in early life) is associated with lower risk of Acute Lymphoid Leukemia.14

So, is cancer a disease of civilization? Yes, in that cancer risk is shaped by many distinctly modern exposures like smoking. And no, because our susceptibility to cancer is simply part of being a multicellular organism made of of cells that can evolve inside the body.4 Cancer happens because cells in our bodies evolve and because our cancer suppression systems aren’t perfect. So, cancer is partly a disease of modernity, but it is also an ancient disease: one with roots that go back deep into our evolutionary history as multicellular organisms. Nevertheless, there is a lot we can do to reduce our risk of certain cancers by change our lifestyle and exposures. And a lot of it comes down to simple advice that your mom has probably been giving you for decades: Eat well and not too much, exercise, don’t smoke, and maybe go outside and play in the dirt every once in a while – just don’t forget the sunscreen.

Read the full Evolutionary Mismatch series:

  1. Introduction: Evolutionary Mismatch and What To Do About It by David Sloan Wilson
  2. Functional Frivolity: The Evolution and Development of the Human Brain Through Play by Aaron Blaisdell
  3. A Mother’s Mismatch: Why Cancer Has Deep Evolutionary Roots by Amy M. Boddy
  4. It’s Time To See the Light (Another Example of Evolutionary Mismatch) by Dan Pardi
  5. Generating Testable Hypotheses of Evolutionary Mismatch by Sudhindra Rao
  6. (Mis-) Communication in Medicine: A Preventive Way for Doctors to Preserve Effective Communication in Technologically-Evolved Healthcare Environments by Brent C. Pottenger
  7. The Darwinian Causes of Mental Illness by Eirik Garnas
  8. Is Cancer a Disease of Civilization? by Athena Aktipis
  9. The Potential Evolutionary Mismatches of Germicidal Ambient Lighting by Marcel Harmon
  10. Do We Sleep Better Than Our Ancestors? How Natural Selection and Modern Life Have Shaped Human Sleep by Charles Nunn and David Samson
  11. The Future of the Ancestral Health Movement by Hamilton M. Stapell
  12. Humans: Smart Enough to Create Processed Foods, Daft Enough to Eat Them by Ian Spreadbury
  13. Mismatch Between Our Biologically Evolved Educative Instincts and Culturally Evolved Schools by Peter Gray
  14. How to Eliminate Going to the Dentist by John Sorrentino
  15. Public Health and Evolutionary Mismatch: The Tragedy of Unnecessary Suffering and Death by George Diggs
  16. Is Shame a Bug or a Feature? An Applied Evolutionary Approach by Nando Pelusi
  17. The “Benefits,” Risks, and Costs of Routine Infant Circumcision by Stephanie Welch
  18. An Evolutionary Perspective on the Real Problem with Increased Screen Time by Glenn Geher
  19. Did Paleolithic People Suffer From Kidney Disease? by Lynda Frassetto
  20. The Physical Activity Mismatch: Can Evolutionary Perspectives Inform Exercise Recommendations? by James Steele


  1. Aktipis A. “Cancer Susceptibility— Not All Bad?” [Internet]. Center for Evolution and Medicine. 2016 [cited 2018 Aug 12]. Available from: https://evmed.asu.edu/blog/cancer-susceptibility%E2%80%94-not-all-bad
  2. Aktipis CA, Nesse RM. “Evolutionary Foundations for Cancer Biology,” Evol Appl. 2013;6:144–59.
  3. Merlo LF, Pepper JW, Reid BJ, Maley CC. “Cancer as an Evolutionary and Ecological Process,” Nat Rev Cancer. 2006;6:924–35.
  4. Aktipis A. “Cancer Has Been With Us Since the Origins of Multicellularity, and It’s Not Going Anywhere,” [Internet] Slate Magazine 2017 [cited 2018 Jun 3]. Available from: http://www.slate.com/articles/technology/future_tense/2017/04/cancer_has_been_with_us_since_the_origins_of_multicellularity.html
  5. Jablonski NG, Chaplin G. “Human Skin Pigmentation as an Adaptation to UV Radiation,” Proc Natl Acad Sci USA 2010;107:8962–8.
  6. U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program. Report on Carcinogens, Eleventh Edition [Internet]. 2011. Report No.: Archived April 20, 2009, at the Wayback Machine. Available from: https://web.archive.org/web/20090507123840if_/http://ntp.niehs.nih.gov/ntp/roc/eleventh/known.pdf
  7. Khuder SA. “Effect of Cigarette Smoking on Major Histological Types of Lung Cancer: A Meta-Analysis,” Lung Cancer 2001;31:139–48.
  8. Bouvard V, Loomis D, Guyton KZ, Grosse Y, Ghissassi FE, Benbrahim-Tallaa L, et al. “Carcinogenicity of Consumption of Red and Processed Meat. Lancet Oncol. 2015;16:1599–600.
  9. Slattery ML, Benson J, Berry TD, Duncan D, Edwards SL, Caan BJ, et al. “Dietary Sugar and Colon Cancer,” Cancer Epidemiol Biomarkers Prev. 1997;6:677–85.
  10. Samad AKA, Taylor RS, Marshall T, Chapman MAS. “A Meta-Analysis of the Association of Physical Activity with Reduced Risk of Colorectal Cancer,” Colorectal Dis. 2005;7:204–13.
  11. Marlowe FW. “Hunter‐Gatherers and Human Evolution,” Evolutionary Anthropology 2005;14:54–67 %@ 1520–6505.
  12. Centers for Disease Control and Prevention. National Vital Statistics Report: Final Data for 2013 [Internet]. Vol. 64. 2015. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf
  13. Aktipis CA, Ellis BJ, Nishimura KK, Hiatt RA. “Modern Reproductive Patterns associated with Estrogen Receptor Positive but not Negative Breast Cancer Susceptibility,” Evolution, Medicine, and Public Health [Internet]. 2014; Available from: http://dx.doi.org/10.1093/emph/eou028 %U http://emph.oxfordjournals.org/content/early/2014/11/10/emph.eou028.abstract
  14. Greaves M. “Infection, Immune Responses and the Aetiology of Childhood Leukaemia,” Nat Rev Cancer 2006;6:193–203.

Published On: April 2, 2019

Athena Aktipis

Athena Aktipis

Athena Aktipis is a cooperation theorist, cancer biologist and social psychologist who studies cooperation across systems from human sharing to the evolution of multicellularity and cancer. She is an Assistant Professor in the Department of Psychology, co-Director of The Human Generosity Project, co-leader of the Arizona Cancer Evolution Center and a member of the Center for Evolution and Medicine and the Biodesign Center for Immunotherapy, Vaccines, and Virotherapy at Arizona State University. She is the author of Evolution in the Flesh and The Cheating Cell: How Evolution Helps Us Understand and Treat Cancer.


  • Mike Wilson says:

    No mention of age? What is the average age at which the cancers mentioned occur? Is that older or younger than the typical historic age of reproduction in human populations? Is that older or younger than the useful age of individuals to a group (including the grandmother hypothesis/effect)?
    We now live on average well beyond 50 years but our cells, in general, have not evolved to enjoy life beyond that.
    I believe advancements in medicine have played an ironic roll in the incease in the incidence of cancer and allowed us to live long enough to to suffer the scourges of the modern world.

    • Doctor Sam says:

      You took the words out of my mouth. I was looking for this exact point in the replies.


      As we have an older population with less other things to kill you before you get cancer, it becomes more common. As we get rid of other causes of death, it becomes relatively more significant.

      • Peter van den Engel says:

        I know about three people in my direct environment who died from cancer around the age of 60. This is not very old, and one of them was not a smoker. Peoples diets on avarage do not differ very much.
        Although all three of them had problematic family/ job situations they were involved in driving them crazy. Surpressing them of course, as if everything was normal.

  • Not a Doctor, but.... says:

    Your statement on eating more, exercising less and getting fat causes X, Y, and Z states the long term conventional wisdom that is increasingly being shown to have no scientific basis (See Big Fat Surprise by Nina Teicholz) yet nonetheless prompted dietary advice (low fat, high sugar/carb) that has – potentially – devastatingly led to the rise and prevalence of Western diseases as sugar and refined carbs are introduced and consumption of such increases in populations – cardiovascular, diabetes, inflammatory, cancer, etc. (See Gary Taubes, The Case Against Sugar). The basic point of it all is that hormones (insulin) regulate the body’s fat growth like they regulate everything else, what you eat matters (food that spikes insulin levels) not really how much you eat; saying getting fat alters hormonal mechanisms is backwards. This is a very interesting possibility that is receiving more attention and research. Suggest reading those two books or calling the authors and hearing them out.

  • Cancer says:

    This is amazing!! Very important issue

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