Highlights
- •Infectious agents are responsible for a high proportion of cancer in Italy.
- •Helicobacter pylori is the main cancer-related infectious agent.
- •Most infectious-related cancers are preventable.
Abstract
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.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Accepted:
January 10,
2023
Received in revised form:
December 20,
2022
Received:
November 10,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
