Narrative reviewindependent cross-checkabstract checked I-CAN-122 standard review
Hallmarks of cancer
Hallmarks of cancer: the next generation.
Overview
Hanahan D et al.. Cell 2011 · PMID 21376230 · DOI 10.1016/j.cell.2011.02.013
Cancers acquire the ability to escape immune destruction; this is why they can grow despite immunity.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Define cancer capabilities.
- How was the study done?
Review.
- How many people, animals or samples were studied?
Not applicable.
- What was actually found?
Immune evasion is a hallmark.
- How large was the observed effect?
Not applicable.
- What do the results mean in everyday life?
Tumours hide from immunity; this is a disease feature.
- What are the study's limitations?
Conceptual.
- What does it say about Elawady's specific claim?
Partly explains Elawady's observation, not his conclusion.
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Any purpose of cancer.
Scientific in-depth review
1. Full reference
- Authors
- Hanahan D et al.
- Journal
- Cell
- Year
- 2011
- Identifier
- PMID 21376230 DOI 10.1016/j.cell.2011.02.013
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Worldwide Cancer Research (PubMed)
2. Research question
Which capabilities define cancer?
3. Study design and population
- Study design
- Narrative review – Conceptual review
- Population
not applicable
- Country
International
- Period
Published 2011
- Sample size
not applicable
- Inclusion and exclusion criteria
not applicable
4. Methods and endpoints
- Exposure / intervention
not applicable
- Comparator
not applicable
- Endpoints
not applicable
- Statistical methods
not applicable
5. Actual results
- Results
Lists hallmarks including sustaining proliferative signalling, resisting cell death, invasion and metastasis; adds 'reprogramming of energy metabolism and evading immune destruction' as emerging hallmarks; inflammation and genome instability as enabling characteristics.
- Absolute risks
not applicable
- Authors' conclusion
Hallmarks are an organizing principle for cancer biology.
6. Strengths
- Highly influential consensus framework
7. Weaknesses
- Conceptual
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Review.
9. Assessment of the statistical interpretation
Not applicable.
10. Relevance to the specific claim
Supports the kernel that tumours evade immune destruction - immune evasion is an acquired capability of cancer, not acceptance by the body.
11. Independent contrary findings
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Explains why tumours grow despite immunity; does not imply the body 'wants' the tumour.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | indirect |
| Reproducibility | unknown |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- The immune system does not fight cancer (no antibodies form against it), which shows the body accepts the tumour; therefore attacking it with chemotherapy is wrong. – Studies with mixed or unclear results
- Cancer is the body's own plan ('a self plan'): body cells are ordered to transform because this was necessary for the person's life; it is not caused by external agents. – Studies with mixed or unclear results