CREEC, 911 Avenue Agropolis, BP 64501, 34394 Montpellier, Cedex 5, France; MIVEGEC, UMR IRD/CNRS/Université de Montpellier, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France.
MIVEGEC, UMR IRD/CNRS/Université de Montpellier, 911 Avenue Agropolis, BP 64501, 34394 Montpellier Cedex 5, France; International Center for Mathematical and Computational Modeling of Complex Systems (UMI IRD/Sorbonne Université UMMISCO), 32 Avenue Henri Varagnat, 93143 Bondy Cedex, France.
Infect Genet Evol. 2018 Jul;61:189-196. doi: 10.1016/j.meegid.2018.03.016. Epub 2018 Mar 23.
It is now well supported that 20% of human cancers have an infectious causation (i.e., oncogenic agents). Accumulating evidence suggests that aside from this direct role, other infectious agents may also indirectly affect cancer epidemiology through interactions with the oncogenic agents within the wider infection community. Here, we address this hypothesis via analysis of large-scale global data to identify associations between human cancer incidence and assemblages of neglected infectious agents. We focus on a gradient of three widely-distributed cancers with an infectious cause: bladder (2% of recorded cancer cases are due to Shistosoma haematobium), liver (60% consecutive to Hepatitis B and C infection) and stomach (Helicobacter pylori is associated with ~70% of cases). We analyzed countries in tropical and temperate regions separately, and controlled for many confounding social and economic variables. First, we found that particular assemblages of bacteria are associated with bladder cancer incidences. Second, we observed a specific and robust association between helminths and liver cancer incidences in both biomes. Third, we show that certain assemblages of viruses may facilitate stomach cancer in tropical area, while others protect against its development in temperate countries. Finally, we discuss the implications of our results in terms of cancer prevention and highlight the necessity to consider neglected diseases, especially in tropics, to adapt public health strategies against infectious diseases and cancer.
现在已经有充分的证据表明,20%的人类癌症具有传染性病因(即致癌因子)。越来越多的证据表明,除了这种直接作用外,其他传染性病原体也可能通过与更广泛感染群体中的致癌因子相互作用,间接地影响癌症流行病学。在这里,我们通过分析大规模的全球数据来验证这一假设,以确定人类癌症发病率与被忽视的传染性病原体组合之间的关联。我们专注于三种具有传染性病因的广泛分布的癌症:膀胱癌(约 2%的记录癌症病例是由曼氏血吸虫引起的)、肝癌(约 60%的病例与乙型肝炎和丙型肝炎感染有关)和胃癌(幽门螺杆菌与约 70%的病例有关)。我们分别分析了热带和温带地区的国家,并控制了许多混杂的社会和经济变量。首先,我们发现某些特定的细菌组合与膀胱癌发病率有关。其次,我们观察到在两个生物群落中,寄生虫与肝癌发病率之间存在特定而稳健的关联。第三,我们表明,某些病毒组合可能在热带地区促进胃癌的发生,而其他病毒组合则可能在温带国家保护其免受发展。最后,我们根据癌症预防的角度讨论了我们的研究结果的意义,并强调了有必要考虑被忽视的疾病,尤其是在热带地区,以适应针对传染病和癌症的公共卫生策略。