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The causes of occupational cancers associated with certain industries have been identified through epidemiological studies and the causative agents equated with initiation. Thus, the genotoxic chemical β-naphthylamine (2-naphthylamine) previously used in the rubber industry caused bladder cancer, whereas ionising radiation from atomic bombs had widespread carcinogenic effects because of the DNA damage it caused (see Chapter 7). Clear-cut as these examples are, it is difficult to prove an initiation and promotion requirement for common cancers like those of colon, prostate and breast. 10, both damaging and proliferative influences are continuous. This would be correct for damaging events of endogenous origin, such as free-radical formation or incomplete repair of misaligned bases, but it does not preclude additional exposures to exogenous carcinogens, such as ultraviolet light and drugs (see Chapter 7). Proliferative signals could derive from exogenous factors such as diet, viral infection and hormones (contraceptive pills, hormone replacement therapy) or endogenous sources such as hormonal changes.