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The cancer burden attributable to biologic agents.

David Schottenfeld1, Jennifer Beebe-Dimmer2

  • 1Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.

Annals of Epidemiology
|December 20, 2014
PubMed
Summary

Infectious agents cause a significant portion of global cancers, particularly in low-income nations. Key culprits include hepatitis B and C viruses, human papillomaviruses, and Helicobacter pylori.

Keywords:
Attributable riskHelicobacter PyloriHepatitis BHepatitis CHuman papillomavirusPopulation attributable fraction

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Area of Science:

  • Epidemiology
  • Oncology
  • Infectious Diseases

Background:

  • Biologic and infectious agents are implicated in a proportion of cancer diagnoses worldwide.
  • Understanding the global burden of infection-attributed cancers is crucial for public health initiatives.

Purpose of the Study:

  • To quantify the proportion of cancer cases attributable to infectious agents globally and in the United States.
  • To review epidemiologic studies estimating the population attributable fraction of cancers linked to infectious agents.

Main Methods:

  • Systematic review of cohort and case-control studies published since 2000.
  • Estimation of population attributable fractions using relative risk and exposure prevalence data for oncogenic infectious agents.

Main Results:

  • Infectious agents account for 20-30% of cancers in low- and middle-income countries, versus 5-10% in industrialized nations.
  • Hepatitis B virus, hepatitis C virus, human papillomaviruses, and Helicobacter pylori are responsible for over 90% of infection-attributed global cancers.

Conclusions:

  • Epidemiologic and molecular studies confirm the significant role of infectious agents in global cancer incidence.
  • Findings support the development of vaccines for hepatitis B virus and human papillomaviruses, and strategies for Helicobacter pylori eradication.