Nonetheless, some CIS pairs do break from this trend; for instance, insertions mutating Notch1 in the presence of an existing Rai17 insertion (p value = 0.001) appear to be more strongly selected for than insertions mutating Rai17 in the presence of an existing Notch1 insertion (0.0356). The gene discussed is ZMIZ1; the disease is in situ carcinoma.