These create novel binding sites for transcription factors,19 and have been identified in many cancers including melanoma (71%),20 glioblastomas (100%),21 adrenocortical carcinomas (12%),22 small cell carcinoma of the bladder (100%)23 and thyroid cancers (8%–33%).24 The two most common TERT promoter alterations are single nucleotide base changes (cytosine to thymine transitions) at positions chr5:1,295,228 (C228T) and chr5:1,295,250 (C250T). Here, TERT is linked to cancer.