DNA damage can occur endogenously through normal cellular processes like respiration or replication errors, or exogenously through environmental factors like radiation, chemicals, and alkylating agents used in chemotherapy. Common types of DNA damage include depurination, deamination of cytosine and adenine, alkylation of bases, insertion/deletions of nucleotides, base analog incorporation, cross-linkages induced by bifunctional alkylating agents and UV light, and oxidative free radical formation. This damage can lead to mutations in the DNA sequence, including point mutations like missense, nonsense, and silent mutations, or frameshift mutations involving insertions, deletions, or inversions.