Pisani, P., Parkin, D. M., Muñoz, N. & Ferlay, J.. Cancer and infection estimates of the attributable fraction in 1990. Cancer Epidemiol Biomarkers Prev 6: 387-400 (original) (raw)
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Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis
The Lancet Global Health
Background Infectious pathogens are strong and modifiable causes of cancer. The aim of this study was to improve estimates of the global and regional burden of infection-attributable cancers to inform research priorities and facilitate prevention efforts. Methods We used the GLOBOCAN 2018 database of cancer incidence and mortality rates and estimated the attributable fractions and global incidence for specific anatomical cancer sites, subsites, or histological subtypes known to be associated with ten infectious pathogens classified as human carcinogens. We calculated absolute numbers and age-standardised incidence rates (ASIR) of infection-attributable cancers at the country level. Estimates were stratified for sex, age group, and country, and were aggregated according to geographical regions and World Bank income groups. Findings We found that, for 2018, an estimated 2•2 million infection-attributable cancer cases were diagnosed worldwide, corresponding to an infection-attributable ASIR of 25•0 cases per 100 000 person-years. Primary causes were Helicobacter pylori (810 000 cases, ASIR 8•7 cases per 100 000 person-years), human papillomavirus (690 000, 8•0), hepatitis B virus (360 000, 4•1) and hepatitis C virus (160 000, 1•7). Infection-attributable ASIR was highest in eastern Asia (37•9 cases per 100 000 person-years) and sub-Saharan Africa (33•1), and lowest in northern Europe (13•6) and western Asia (13•8). China accounted for a third of worldwide cancer cases attributable to infection, driven by high ASIR of H pylori (15•6) and hepatitis B virus (11•7) infection. The cancer burden attributed to human papillomavirus showed the clearest relationship with country income level (from ASIR of 6•9 cases per 100 000 personyears in high-income countries to 16•1 in low-income countries). Interpretation Infection-attributable cancer incidence, in addition to the absolute number of cases, allows for refined geographic analyses and identification of populations with a high infection-associated cancer burden. When cancer prevention is largely considered in a non-communicable disease context, there is a crucial need for resources directed towards cancer prevention programmes that target infection, particularly in high-risk populations. Such interventions can markedly reduce the increasing cancer burden and associated mortality.
Infection as a causal factor of cancer
2012
By 2030 nearly one in five of all new cases of cancer in the world, and nearly one in six cancer deaths, will occur in Commonwealth member states (Ferley et al., 2010). Projections of the International Agency for Research on Cancer (IARC) indicate that the number of new cases of cancer in the Commonwealth will rise by more than 77 per cent – from 2,263,427 to 4,003,875 – and cancer deaths by more than 81 per cent – from 1,455,050 to 2,592,240 (ibid.). Lowand middle-income member states, particularly those in South Asia, will bear the brunt of this unfolding cancer pandemic where it is estimated that the number of new cancer cases will rise by 72 per cent and cancer deaths by more than 80 per cent (ibid.). Only effective prevention can reduce the incidence of cancer. A first step towards this is an understanding of the factors that predispose to cancer. These factors differ, often quite markedly, between the more and less developed countries and across different geographical regions....
Epidemiology of Virus Infection and Human Cancer
Viruses and Human Cancer, 2013
The International Agency for Research on Cancer (IARC) has comprehensively assessed the human carcinogenicity of biological agents. Seven viruses including Epstein-Barr virus (EBV), hepatitis B virus (HBV), hepatitis C virus (HCV), Kaposi's sarcoma herpes virus (KSHV), human immunodeficiency virus, type-1 (HIV-1), human T cell lymphotrophic virus, type-1 (HTLV-1), and human papillomavirus (HPV) have been classified as Group 1 human carcinogens by IARC. The conclusions are based on the findings of epidemiological and mechanistic studies. EBV, HPV, HTLV-1, and KSHV are direct carcinogens; HBV and HCV are indirect carcinogens through chronic inflammation; HIV-1 is an indirect carcinogen through immune suppression. Some viruses may cause more than one cancer, while some cancers may be caused by more than one virus. However, only a proportion of persons infected by these
Infectious Aetiology of Cancer: Developing World Perspective
Modern Approaches To Quality Control, 2011
Infection attributable cancers contribute over 1/4 th of all cancers in the developing countries (26.3%) compared to the developed countries (7.7%), (Parkin, 2006). Overwhelming majority are related to viral infections. In contrast to other carcinogens where it is usually a 'hit and run' kind of situation, with infectious agents particularly viruses one may precisely demonstrate and prove its presence and integration within host neoplastic cells. Oncogenic DNA viral genome incorporates itself directly into host cells DNA while oncogenic RNA viral genome is transcribed into host cell DNA by reverse transcriptase. Neoplastic transformation usually follows. Oncogenic mechanisms include acting as promoter, transforming protooncogenes into oncogenes. Credit goes to Dr Peyton Rous, a noble laureate pathologist who demonstrated that it was possible to transmit tumours from one animal to other like transmission of an infection. Human tumours with proven or proposed viral aetiology include 'Human papillomavirus (HPV)', Epstein-Barr Virus (EBV), Hepatitis B and C viruses, RNA retroviruses like 'Human T-lymphotropic virus (HTLV1)', 'Human Herpes Virus-8 (HHV-8). Bacteria with proven carcinogenic potential include 'Helicobacter pylori'. Among fungi aflatoxins produced by 'Aspergillus flavus' are potent carcinogens. Among parasites 'Schistosoma' and 'Clonorchis sinensis' are implicated in the causation of cancer. 2. Human papillomavirus (HPV) HPV is a small epitheliotropic, non enveloped DNA virus belonging to papovaviridae family. Its genome comprises 7000-8000 base pairs of double-stranded closed-circular DNA. At least 70 genetically distinct types of HPV have been identified in humans. According to their oncogenic potential HPV is classified in a high oncogenic risk group (i.e.
Annals of Ibadan Postgraduate Medicine, 2007
The epidemiology of several types of cancers indicate the involvement of several transmissible agents in their development, and in most cases, these seem to be viruses. The classic examples are Burkitt's lymphoma, nasopharyngeal carcinoma (EBV), hepatocellular carcinoma (HBV), and cervical carcinoma (HPV). Most of these cancers show substantial variations in their incidence in different parts of the world and in particular countries, they present significant health problems. Worldwide, infections account for up to 20% of all cancers. Also, there is now ample evidence implicating infection with the Helicobacter pylori in the occurrence of gastric carcinoma and gastric lymphoma, and infection with Schistosoma haematobium in the occurrence of the squamous cell carcinoma of the urinary bladder.The impact of these infections on the burden of cancer worldwide is becoming increasingly evident because they are largely responsible for the cascade of opportunistic malignancies associated with AIDS. The burden is heaviest among populations in developing countries, reflecting the impact of very early infection with these agents on subsequent risk of cancer. There are currently no vaccines available to prevent these chronic infections, other than for HBV. As a result, changes in behaviour hold the most promise for prevention.
Burden of Cancers Attributable to Infectious Agents in Nigeria: 2012–2014
Frontiers in Oncology, 2016
Infections by certain viruses, bacteria, and parasites have been identified as risk factors for some cancers. In Nigeria, like many other developing countries, infections remain a leading cause of morbidity and mortality. While there are data on the incidence of different cancers in Nigeria, there has been no study of cancers attributable to infections. This study was carried out to determine the burden of cancers attributable to infections using data from two population-based cancer registries (PBCRs) in Nigeria. Methods: We obtained data on cancers associated with EBV, human papillomavirus (HPV), hepatitis B and C, HIV, HHV8, Helicobacter pylori, and Schistosoma spp. from the databases of Abuja and Enugu cancer registries in Nigeria. We used populationattributable fraction for infections-associated cancers in developing countries that are based on prevalence data and relative risk estimates from previous studies. results: The PBCRs reported 4,336 incident cancer cases [age standardized incidence rate (ASR) 113.9 per 100,000] from 2012 to 2014, of which 1,627 (37.5%) were in males and 2,709 (62.5%) were in females. Some 1,030 (23.8%) of these cancers were associated with infections (ASR 44.4 per 100,000), while 951 (22.0%) were attributable to infections (ASR 41.6 per 100,000). Cancers of the cervix (n = 392, ASR 28.3 per 100,000) and liver (n = 145, ASR 3.4 per 100,000); and non-Hodgkin's lymphoma (n = 110, ASR 2.5 per 100,000) were the commonest infections-associated cancers overall. The commonest infectious agents associated with cancers in this population were HPV, EBV, hepatitis B and C, HIV, and HHV8. conclusion: Our results suggest that 23.8% of incident cancer cases in this population were associated with infections, while 22.0% were attributable to infections. The infections attributable cancers are potentially preventable with strategies, such as vaccination, risk factor modification, or anti-infective treatment.
Cancers Attributable to Infectious Agents: an Ecological Study in Asia
Asian Pacific Journal of Environment and Cancer
Infections are a major contributor to cancer, especially in developing countries. Infections through the virus, bacteria and parasites are the most and most preventable causes of cancer in the world. The aim of the current study was to investigate the epidemiology of cancer-related infections in Asia. We considered 4 infectious agents classified as carcinogenic to human beings by the International Agency for Research on Cancer. We calculated the number of new cancer cases in 2012 attributable to infections by country, by combining cancer incidence estimates (from GLOBOCAN 2012) with the estimates of attributable fraction (AF) for the infectious agents. AF estimates were calculated from the prevalence of infection in cancer cases for the infection (for some sites). According to data registered in 2012, about 14 million new cases of cancer were detected worldwide of which 2. 2 million people (15.4%) diagnosed with cancer due to infection. The highest incidence of infectious cancers re...
Causal role of infectious agents in cancer: An overview
Caspian Journal of Internal Medicine, 2017
Cancer is a complex group of diseases with multiple eventual causes. The underlying causes are not fully known. Thus, learning more about the known causes of cancer is an important issue. Moreover, among these factors, infection and its association to cancers is controversial. Although, it seems that the genome instability of the cells can initiate cancer development. The purpose of this review was to present the role of infection in the development of cancer. Infectious agents, such as hepatitis B (HBV) and C viruses (HCV), Epstein-Barr virus (EBV), human papillomavirus (HPV), human immunodeficiency virus type 1 (HIV-1), Helicobacter pylori (H. pylori) and Streptococcus bovis (S. bovis) contribute to the pathogenesis of different cancers. These cancers include hepatocellular carcinoma, Burkitt's lymphoma, nasopharyngeal carcinoma, cervical cancers, non-Hodgkin lymphoma, Kaposi sarcoma, adenocarcinoma and lymphoma. Screenings of infectious diseases in cancer patients may open up areas of research in the identification of optimizing cancer control strategies.
Cancer, 2008
Background Mortality statistics are traditionally used to quantify the burden of disease and to determine the relative importance of the various causes of death. Some of the most frequently used indices to quantify the burden of disease are the years of potential life lost (YPLL) and years of potential productive life lost (YPPLL). These two measures reflect the mortality trends in younger age groups and they provide a more accurate picture of premature mortality. This study was carried out to determine YPLL, YPPLL and cost of productivity lost (CPL) due to premature mortality caused by selected causes of deaths in Tanzania. Methods and findings Malaria, respiratory diseases, HIV/AIDS, tuberculosis, cancers and injuries were selected for this analysis. The number of deaths by sex and age groups were obtained from hospital death registers and ICD-10 reporting forms in 39 public hospitals in Tanzania, covering a period of 2006-2015. The life expectancy method and human capital approach were used to estimate the YPLL, YPPLL and CPL due to premature mortality. During 2006-2015, malaria, HIV/AIDS, tuberculosis, respiratory diseases, HIV+tuberculosis, cancer and injury were responsible for a total of 96,834 hospital deaths, of which 46.4% (n = 57,508) were among individuals in the productive age groups (15-64 years). The reported deaths contributed to 2,850,928 YPLL (female = 1,326,724; male = 1,524,205) with an average of 29 years per death. The average YPLL among females (32) was higher than among males (28). Malaria (YPLL = 38 per death) accounted for over one-third (35%) of the total YPLL. There was a significant increase in YPLL due to the selected underlying causes of death over the 10-year period. Deaths from the selected causes resulted into 1,207,499 YPPLL (average = 21 per death). Overall, HIV/AIDS contributed to the highest YPPLL (323,704), followed by malaria (243,490) and injuries (196,505). While there was a general decrease in YPPLL due to malaria, there was an increase of YPPLL due to HIV/AIDS, respiratory diseases, cancer and injuries during the 10-year period. The total CPL due to the six diseases was US$ 148,430,009 for 10 years. The overall CPL was higher among males than females