Oncogenes: Mutations in proto-oncogenes convert them into oncogenes, which drive uncontrolled cell proliferation. Tumor Suppressor Genes: Inactivation of tumor suppressor genes removes the brakes on cell growth and division. DNA Repair Mechanisms: Defects in DNA repair mechanisms lead to the accumulation of mutations. Epigenetic Changes: Alterations in DNA methylation and histone modification can also contribute to carcinogenesis.