Global burden of cancers attributable to infections in 2008: a review and synthetic analysis
Global burden of cancers attributable to infections in 2008: a review and synthetic analysis
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DOI：
10.1016/s1470-2045(12)70137-7
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发表时间：
2012-06-01
期刊：
影响因子：
51.1
通讯作者：
Plummer, Martyn
中科院分区：
文献类型：
--
作者：
de Martel, Catherine;Ferlay, Jacques;Plummer, Martyn
背景 某些病毒、细菌和寄生虫的感染已被确定为特定癌症的强烈危险因素。有必要更新它们各自对全球癌症负担的贡献。方法我们考虑了被国际癌症研究机构归类为人类致癌物的传染源。我们使用 2008 年估计癌症发病率的统计数据计算了全球和八个地理区域的人口归因分数。当关联性非常强时，计算是基于癌症病例而不是一般人群的感染流行率。对感染流行率和相对风险的估计是从已发表的数据中提取的。调查结果在 2008 年发生的 1270 万个新癌症病例中，传染原的人群归因分数 (PAF) 为 16.1%，这意味着大约 200 万个新癌症病例可归因于感染。这一比例在欠发达国家 (22.9%) 高于较发达国家 (7.4%)，并且从澳大利亚和新西兰的 3.3% 到撒哈拉以南非洲的 32.7% 不等。幽门螺杆菌、乙型和丙型肝炎病毒以及人乳头瘤病毒导致了 190 万例病例，主要是胃癌、肝癌和子宫颈癌。在女性中，子宫颈癌约占感染相关癌症负担的一半；在男性中，肝癌和胃癌占80%以上。大约 30% 的感染病例发生在 50 岁以下的人群中。解释 每年大约有 200 万癌症病例是由传染源引起的。应用现有的预防感染的公共卫生方法，例如疫苗接种、更安全的注射实践或抗菌治疗，可能会对全世界未来的癌症负担产生重大影响。
Background Infections with certain viruses, bacteria, and parasites have been identified as strong risk factors for specific cancers. An update of their respective contribution to the global burden of cancer is warranted.Methods We considered infectious agents classified as carcinogenic to humans by the International Agency for Research on Cancer. We calculated their population attributable fraction worldwide and in eight geographical regions, using statistics on estimated cancer incidence in 2008. When associations were very strong, calculations were based on the prevalence of infection in cancer cases rather than in the general population. Estimates of infection prevalence and relative risk were extracted from published data.Findings Of the 12.7 million new cancer cases that occurred in 2008, the population attributable fraction (PAF) for infectious agents was 16.1%, meaning that around 2 million new cancer cases were attributable to infections. This fraction was higher in less developed countries (22.9%) than in more developed countries (7.4%), and varied from 3.3% in Australia and New Zealand to 32.7% in sub-Saharan Africa. Helicobacter pylori, hepatitis B and C viruses, and human papillomaviruses were responsible for 1.9 million cases, mainly gastric, liver, and cervix uteri cancers. In women, cervix uteri cancer accounted for about half of the infection-related burden of cancer; in men, liver and gastric cancers accounted for more than 80%. Around 30% of infection-attributable cases occur in people younger than 50 years.Interpretation Around 2 million cancer cases each year are caused by infectious agents. Application of existing public health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on the future burden of cancer worldwide.