Global burden of cancers attributable to infections in 2012: a synthetic analysis
Global burden of cancers attributable to infections in 2012: a synthetic analysis
复制标题
DOI：
10.1016/s2214-109x(16)30143-7
复制
发表时间：
2016-09-01
影响因子：
34.3
通讯作者：
Franceschi, Silvia
中科院分区：
文献类型：
--
作者：
Plummer, Martyn;de Martel, Catherine;Franceschi, Silvia
背景感染某些病毒、细菌和寄生虫是特定癌症的强烈危险因素。随着近5年来新的癌症统计和流行病学发现的积累，我们旨在评估2012年主要致癌物在不同类型癌症中的因果关系。方法我们选择了国际癌症研究机构列为人类致癌物的10种感染源。我们通过将癌症发病率估计值(来自2012年GLOBOCAN)与感染源的归属分数(AF)估计值相结合，计算了2012年可归因于国家/地区的新癌症病例数量。AF估计是根据癌症病例中感染的流行率和感染的相对风险(某些部位)计算出来的。房颤的感染患病率、相对风险和相应的95%CI的估计是通过系统回顾和汇集分析获得的。2012年发现1400万新的癌症病例。200万(15.4%)可归因于致癌感染。全球最重要的感染源是幽门螺杆菌(77万例)、人乳头瘤病毒(64万例)、乙肝病毒(42万例)、丙型肝炎病毒(17万例)和爱泼斯坦-巴尔病毒(12万例)。卡波西肉瘤是撒哈拉以南非洲癌症负担的第二大贡献者。感染的AFS因国家和发展状况的不同而不同--从美国、加拿大、澳大利亚、新西兰和西欧和北欧的一些国家的不到5%到撒哈拉以南非洲的一些国家超过50%。社会经济发展与感染相关癌症的减少有关；然而，为了毫不拖延地减少这些癌症的发病率，应提供基于人群的疫苗接种和筛查和治疗方案。版权所有(C)作者(S)。由爱思唯尔有限公司出版。这是一篇CC BY-NC-ND许可证下的开放获取文章。
Background Infections with certain viruses, bacteria, and parasites are strong risk factors for specific cancers. As new cancer statistics and epidemiological findings have accumulated in the past 5 years, we aimed to assess the causal involvement of the main carcinogenic agents in different cancer types for the year 2012.Methods We considered ten 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 estimates of attributable fraction (AF) for the infectious agents. AF estimates were calculated from the prevalence of infection in cancer cases and the relative risk for the infection (for some sites). Estimates of infection prevalence, relative risk, and corresponding 95% CIs for AF were obtained from systematic reviews and pooled analyses.Findings Of 14 million new cancer cases in 2012, 2 . 2 million (15 . 4%) were attributable to carcinogenic infections. The most important infectious agents worldwide were Helicobacter pylori (770 000 cases), human papillomavirus (640 000), hepatitis B virus (420 000), hepatitis C virus (170 000), and Epstein-Barr virus (120 000). Kaposi's sarcoma was the second largest contributor to the cancer burden in sub-Saharan Africa. The AFs for infection varied by country and development status-from less than 5% in the USA, Canada, Australia, New Zealand, and some countries in western and northern Europe to more than 50% in some countries in sub-Saharan Africa.Interpretation A large potential exists for reducing the burden of cancer caused by infections. Socioeconomic development is associated with a decrease in infection-associated cancers; however, to reduce the incidence of these cancers without delay, population-based vaccination and screen-and-treat programmes should be made accessible and available. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license.