近日,，新一期英國學術刊物《柳葉刀—腫瘤》The Lancet Oncology 刊登報告說,，一項調查顯示全球癌癥病例中約六分之一由可預防或治療的感染引起,，這凸顯了通過防治感染來減少癌癥發(fā)病率的重要性,。
這份報告由位于法國的國際癌癥研究機構完成,，該機構調查了2008年全球184個國家的27種癌癥的數(shù)據(jù),。當年總計有1270萬個新發(fā)癌癥病例,，分析顯示,，其中約200萬個病例是由可預防或治療的感染引起的。
在感染原因中,，位居前列的有幽門螺桿菌,、乙肝和丙肝病毒以及人乳頭瘤病毒，這4種病原體就導致了約190萬個新發(fā)癌癥病例,，它們引發(fā)癌癥的種類包括胃癌,、肝癌和宮頸癌等。
這些病原體引發(fā)的感染現(xiàn)在基本上都有預防或治療的方法,，如有針對乙肝病毒和人乳頭瘤病毒的疫苗,，對幽門螺桿菌則可用抗生素治療,。
從地域來看，雖然全球平均由感染引發(fā)的癌癥占癌癥總病例的六分之一,，但發(fā)達國家的這一比例很低,，如在澳大利亞和新西蘭只有3.3%，而發(fā)展中國家比例很高,，如在撒哈拉沙漠以南非洲地區(qū)達到32.7%,。
因此，這項研究結果凸顯發(fā)展中國家通過防治感染來降低癌癥發(fā)病率,、提高公共衛(wèi)生水平的重要性,。（生物谷Bioon.com）
doi:10.1016/S1470-2045(12)70137-7
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Global burden of cancers attributable to infections in 2008: a review and synthetic analysis
Catherine de Martel MD a, Jacques Ferlay ME a, Silvia Franceschi MD a, Jérôme Vignat MSc a, Freddie Bray PhD a, David Forman PhD a, Dr Martyn Plummer PhD a
Background Infections with certain viruses, bacteria, and parasites have been identified as strong risk factors for specific cancers. An update of their respective contribution to the global burden of cancer is warranted.
Methods We considered infectious agents classified as carcinogenic to humans by the International Agency for Research on Cancer. We calculated their population attributable fraction worldwide and in eight geographical regions, using statistics on estimated cancer incidence in 2008. When associations were very strong, calculations were based on the prevalence of infection in cancer cases rather than in the general population. Estimates of infection prevalence and relative risk were extracted from published data.
Findings Of the 12·7 million new cancer cases that occurred in 2008, the population attributable fraction (PAF) for infectious agents was 16·1%, meaning that around 2 million new cancer cases were attributable to infections. This fraction was higher in less developed countries (22·9%) than in more developed countries (7·4%), and varied from 3·3% in Australia and New Zealand to 32·7% in sub-Saharan Africa. Helicobacter pylori, hepatitis B and C viruses, and human papillomaviruses were responsible for 1·9 million cases, mainly gastric, liver, and cervix uteri cancers. In women, cervix uteri cancer accounted for about half of the infection-related burden of cancer; in men, liver and gastric cancers accounted for more than 80%. Around 30% of infection-attributable cases occur in people younger than 50 years.
Interpretation Around 2 million cancer cases each year are caused by infectious agents. Application of existing public health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on the future burden of cancer worldwide.
Funding Fondation Innovations en Infectiologie (FINOVI) and the Bill & Melinda Gates Foundation (BMGF).
