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. 2018 Sep 3;115(35-36):586-593.
doi: 10.3238/arztebl.2018.0586.

Cancers Due to Infection and Selected Environmental Factors

Thomas Gredner  1 , Gundula Behrens, Christian Stock, Hermann Brenner, Ute Mons
Affiliations

Cancers Due to Infection and Selected Environmental Factors

Thomas Gredner et al. Dtsch Arztebl Int. .

Abstract

Background: Causal relationships with the occurrence of cancer have been established for a number of infections and environmental risk factors.

Methods: Numbers and proportions (population-attributable fractions, PAF) of cancer cases attributable to these factors in Germany were calculated by sex and age groups for ages 35 to 84 years based on population projections, national cancer incidence, exposure data, and published risk estimates.

Results: For 2018, more than 17 600 cancer cases (4.0% of all incident cancers) were estimated to be attributable to infections. The largest contributions come from Helicobacter pylori (n = 8764) and human papillomavirus (n = 7669) infections. Infection with hepatitis B and C, human immunodeficiency virus, and human herpesvirus 8 were estimated to cause 983 cases, 144 cases, and 116 cases, respectively. More than 5400 cancer cases (1.2% of all incident cancers) were estimated to be attributable to selected environmental factors, of which the largest contributor is indoor radon (n = 3185), followed by particulate matter (n = 1049), sunbed use (n = 892), and secondhand smoke (n = 309).

Conclusion: Of all cancers expected in 2018 in Germany, at least 5% are attributable to potentially avoidable infections and environmental factors. Further research should be directed towards more comprehensive identification and quantification of environmental risks as a basis for targeted cancer prevention.

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Figures

Figure 1
Figure 1
Estimated number and proportion of site-specific incident cancer cases attributable to infections among men and women aged 35 to 84 years in Germany for the year 2018. *1 The population-attributable fraction (PAF) for the category “All above cancer types combined” was computed with respect to total cancer incidence (ICD-10 C00–C99 without C44). *2 A joint PAF of all infections was calculated assuming independence of infections (28)
Figure 2
Figure 2
Estimated number and proportion of site-specific incident cancer cases attributable to selected environmental factors among men and women aged 35 to 84 years in Germany for the year 2018. *1A joint PAF of all selected environmental factors was calculated assuming independence of the selected risk factors (28)
Figure 3
Figure 3
Estimated number and proportion of all incident cancer cases (ICD-10 C00-C99 without C44) attributable to the reported lifestyle-related factors, environmental factors and infections among men and women aged 35 to 84 years in Germany for the year 2018
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References

    1. Espina C, Straif K, Friis S, et al. European Code against Cancer 4th edition: environment, occupation and cancer. Cancer Epidemiol. 2015;39(1):84–92. - PubMed
    1. Plummer M, de Martel C, Vignat J, Ferlay J, Bray F, Franceschi S. Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob Health. 2016;4:e609–e616. - PubMed
    1. Plummer M, Franceschi S, Vignat J, Forman D, de Martel C. Global burden of gastric cancer attributable to Helicobacter pylori. Int J Cancer. 2015;136:487–490. - PubMed
    1. Parsonnet J, Hansen S, Rodriguez L, et al. Helicobacter pylori infection and gastric lymphoma. N Engl J Med. 1994;330:1267–1271. - PubMed
    1. De Martel C, Ferlay J, Franceschi S, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012;13:607–615. - PubMed

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