Cancers Attributable to Infections in the US in 2017: A Meta-Analysis.
JAMA Oncol
; 9(12): 1678-1687, 2023 Dec 01.
Article
in En
| MEDLINE
| ID: mdl-37856141
ABSTRACT
Importance Infections are largely modifiable causes of cancer. However, there remains untapped potential for preventing and treating carcinogenic infections in the US. Objective:
To estimate the percentage and number of incident cancers attributable to infections in the US among adults and children for the most recent year cancer incidence data were available (2017). Data Sources A literature search from 1946 onward was performed in MEDLINE on January 6, 2023, to obtain the data required to calculate population attributable fractions for 31 infection-cancer pairs. National Health and Nutrition Examination Survey data were used to estimate the population prevalence of hepatitis B and C viruses and Helicobacter pylori. Study Selection Studies conducted in the US or other Western countries were selected according to specific infection-cancer criteria. Data Extraction andSynthesis:
Data from 128 studies were meta-analyzed to obtain the magnitude of an infection-cancer association or prevalence of the infection within cancer cells. Main Outcomes andMeasures:
The proportion of cancer incidence attributable to 8 infections.Results:
Of the 1â¯666â¯102 cancers diagnosed in 2017 among individuals aged 20 years or older in the US, 71â¯485 (4.3%; 95% CI, 3.1%-5.3%) were attributable to infections. Human papillomavirus (n = 38â¯230) was responsible for the most cancers, followed by H pylori (n = 10â¯624), hepatitis C virus (n = 9006), Epstein-Barr virus (n = 7581), hepatitis B virus (n = 2310), Merkel cell polyomavirus (n = 2000), Kaposi sarcoma-associated herpesvirus (n = 1075), and human T-cell lymphotropic virus type 1 (n = 659). Cancers with the most infection-attributable cases were cervical (human papillomavirus; n = 12â¯829), gastric (H pylori and Epstein-Barr virus; n = 12â¯565), oropharynx (human papillomavirus; n = 12â¯430), and hepatocellular carcinoma (hepatitis B and C viruses; n = 10â¯017). The burden of infection-attributable cancers as a proportion of total cancer incidence ranged from 9.6% (95% CI, 9.2%-10.0%) for women aged 20 to 34 years to 3.2% (95% CI, 2.4%-3.8%) for women aged 65 years or older and from 6.1% (95% CI, 5.2%-7.0%) for men aged 20 to 34 years to 3.3% (95% CI, 1.9%-4.4%) for men aged 65 years or older. Among those aged 19 years or younger, 2.2% (95% CI, 1.3%-3.0%) of cancers diagnosed in 2017 were attributable to Epstein-Barr virus. Conclusions and Relevance Infections were estimated to be responsible for 4.3% of cancers diagnosed among adults in the US in 2017 and, therefore, represent an important target for cancer prevention efforts.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Carcinoma, Hepatocellular
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Epstein-Barr Virus Infections
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Papillomavirus Infections
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Hepatitis B
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Liver Neoplasms
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Neoplasms
Type of study:
Systematic_reviews
Limits:
Adult
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Child
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Female
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Humans
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Male
Language:
En
Journal:
JAMA Oncol
Year:
2023
Document type:
Article