Cancers attributable to infectious agents in Italy
Menée en Italie à partir de données sur l'incidence en 2020 et sur la mortalité en 2017, cette étude estime la part des cancers et des décès attribuable aux agents infectieux (Helicobacter pylori, hépatites B et C, papillomavirus humain, herpèsvirus de type 8, Epstein-Barr, VIH)
Objectives: To provide an evidence-based, comprehensive assessment of the current burden of infection-related cancer in Italy. Methods: We calculated the proportion of cancers attributable to infectious agents (Helicobacter pylori [Hp]; hepatitis B and C viruses [HBV and HCV]; human papillomavirus [HPV]; human herpesvirus-8 [HHV8]; Epstein–Barr virus [EBV]; and human immunodeficiency virus [HIV]) to estimate the burden of infection-related cancer incidence (2020) and mortality (2017). Data on the prevalence of infections were derived from cross-sectional surveys of the Italian population, and relative risks from meta-analyses and large-scale studies. Attributable fractions were calculated based on the counterfactual scenario of a lack of infection. Results: We estimated that 7.6% of total cancer deaths in 2017 were attributable to infections, with a higher proportion in men (8.1%) than in women (6.9%). The corresponding figures for incident cases were 6.5%, 6.9%, and 6.1%. Hp was the first cause of infection-related cancer deaths (3.3% of the total), followed by HCV (1.8%), HIV (1.1%), HBV (0.9%), HPV, EBV, and HHV8 (each ≤0.7%). Regarding incidence, 2.4% of the new cancer cases were due to Hp, 1.3% to HCV, 1.2% to HIV, 1.0% to HPV, 0.6% to HBV, and < 0.5% to EBV and HHV8. Conclusions: Our estimate of 7.6% of cancer deaths and 6.9% of incident cases that were attributable to infections in Italy is higher than those estimated in other developed countries. Hp is the major cause of infection-related cancer in Italy. Prevention, screening, and treatment policies are needed to control these cancers, which are largely avoidable.