The Cancer Burden Attributable to Biologic Agents
A partir d'une revue de la littérature publiée depuis 2000, cette étude américaine analyse la proportion de cancers au niveau mondial attribuables à une exposition à des agents biologiques et infectieux
Purpose : A review of cohort and case-control studies that attempt to quantify the proportion of cancer cases diagnosed in the United States and throughout the world that may be attributed to biologic or infectious agents. Methods : Epidemiologic studies published primarily since the year 2000 are summarized that estimate population attributable fractions (PAFs) based on consensus estimates of relative risk and of the exposure prevalence to putative oncogenic infectious agents in representative populations. Results : The proportion of incident cancers attributable to infectious agents diagnosed in low-and middle-income countries, comprising more than 80% of the world`s population, has been estimated to vary from 20% to 30%, in contrast to a range of ≤ 5% to 10 % in the USA and other highly industrialized populations. More than 90% of the global cancer cases attributed to infectious agents have been caused by hepatitis B virus (HBV), hepatitis C virus (HCV), human papillomaviruses (HPVs), and the gram-negative bacterium, Helicobacter pylori. Conclusions : Epidemiologic and pathologic studies that utilize molecular diagnostic probes and immunologic and biochemical assays have described the substantial impact of infectious agents on global cancer incidence. These compelling observations have stimulated the development of effective HBV and HPV vaccines, and the rationale for eradication of Helicobacter pylori.