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Stage Two: Genetic Alterations Carcinogenic substances such as nitrosamines, polycyclic aromatic hydrocarbons (PAHs), and formaldehyde cause mutations in oncogenes and tumor suppressors (e.g., p53) present in the DNA of the mouth's lining

Analysis of the Kras mutations revealed that the presence of the KRAS G12C mutation had 96% specificity and positive predictive value for lung adenocarcinoma, whereas G12R was 99% specific for pancreatic cancer with a positive predictive value of 86% (57)

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