Antonsson Annika, Wilson Louise F, Kendall Bradley J, Bain Christopher J, Whiteman David C, Neale Rachel E
QIMR Berghofer Medical Research Institute, Queensland.
School of Medicine, The University of Queensland.
Aust N Z J Public Health. 2015 Oct;39(5):446-51. doi: 10.1111/1753-6405.12445.
To estimate the proportion and numbers of cancers in Australia in 2010 attributable to infectious agents.
The population attributable fraction (PAF) and number of cancers caused by hepatitis B and C viruses (HBV, HCV), Helicobacter pylori and human immunodeficiency virus (HIV) were calculated using standard formulae incorporating prevalence of infection in the Australian population, the relative risks associated with that infection and cancer incidence. For cancers with very strong associations to the infectious agent (Epstein-Barr virus [EBV], human papillomavirus [HPV] and HIV/Kaposi's sarcoma herpes virus [KSHV]), calculations were based on viral prevalence in the tumour.
An estimated 3,421 cancers (2.9% of all cancers) in Australia in 2010 were attributable to infections. Infectious agents causing the largest numbers of cancers were HPV (n=1,706), H. pylori (n=793) and HBV/HCV (n=518). Cancer sites with the greatest number of cancers caused by infections were cervix (n=818), stomach (n=694) and liver (n=483). Cancers with highest proportions attributable to infectious agents were Kaposi's sarcoma (100%), cervix (100%), nasopharynx (87%), anus (84%) and vagina (70%).
Infectious agents cause more than 3,000 cancers annually in Australia.
Opportunities for cancer prevention through infection control are considerable, even in a 'first world' nation like Australia.
估算2010年澳大利亚因感染因素导致的癌症比例及数量。
采用标准公式计算乙型和丙型肝炎病毒(HBV、HCV)、幽门螺杆菌及人类免疫缺陷病毒(HIV)所致癌症的人群归因分数(PAF)及数量,公式中纳入了澳大利亚人群的感染率、该感染与癌症发病率的相对风险。对于与感染因素关联极强的癌症(爱泼斯坦-巴尔病毒[EBV]、人乳头瘤病毒[HPV]及HIV/卡波西肉瘤疱疹病毒[KSHV]),计算基于肿瘤中的病毒流行率。
估计2010年澳大利亚有3421例癌症(占所有癌症的2.9%)归因于感染。导致癌症数量最多的感染因素为HPV(1706例)、幽门螺杆菌(793例)及HBV/HCV(518例)。因感染导致癌症数量最多的癌种部位为子宫颈(818例)、胃(694例)及肝脏(483例)。归因于感染因素比例最高的癌症为卡波西肉瘤(100%)、子宫颈癌(100%)、鼻咽癌(87%)、肛门癌(84%)及阴道癌(70%)。
在澳大利亚,感染因素每年导致超过3000例癌症。
即便在澳大利亚这样的“发达国家”,通过控制感染来预防癌症的机会也相当可观。