1 in 8 cancer cases worldwide are caused by infections, study finds

研究发现：全球八分之一的癌症病例由感染引起

Researchers estimate infections caused 2.3 million new cancer cases worldwide in 2024. 研究人员估计，2024年全球有230万例新发癌症病例是由感染引起的。

For many people, sun exposure, smoking and family history are the first thoughts that come to mind regarding cancer risk factors. While infections are rarely high on the list, new research shows one in eight cancers worldwide are actually caused by them. These viruses, bacteria and other microbes are the focus of a new paper published Monday in The Lancet Oncology that linked an estimated 2.3 million new cancer cases in 2024 — 12 per cent of all new cases — to these infectious agents. 对许多人来说，提到癌症风险因素，首先想到的是日晒、吸烟和家族病史。虽然感染很少被列在首位，但最新研究表明，全球八分之一的癌症实际上是由感染引起的。周一发表在《柳叶刀-肿瘤学》（The Lancet Oncology）上的一篇新论文重点研究了这些病毒、细菌和其他微生物，研究将2024年估计230万例新发癌症病例（占所有新发病例的12%）与这些感染源联系了起来。

A team of researchers at The International Agency for Research on Cancer (IARC), an arm of the World Health Organization, conducted the study. They found the largest number of cancer cases attributed to infections globally were caused by the bacterium Helicobacter pylori, which can increase the risk of stomach cancer and accounted for 760,000 cases, predominantly in eastern Asia. 世界卫生组织下属的国际癌症研究机构（IARC）的研究团队进行了这项研究。他们发现，全球范围内由感染引起的癌症病例中，数量最多的是由幽门螺杆菌（Helicobacter pylori）引起的，这种细菌会增加胃癌风险，导致了76万例病例，主要集中在东亚地区。

Human papillomavirus (HPV) followed close behind. HPV, which causes 100 per cent of cervical cancer cases and also anal, vulvar, vaginal, penile and some head and neck cancers, accounted for nearly 750,000 new cases globally, with high rates in sub-Saharan Africa. Hepatitis B virus (HBV) and hepatitis C virus (HCV) were also linked to a significant number of liver cancer cases. For the first time, researchers linked even more cancers to infections, expanding their list to include 16 additional ones. 人乳头瘤病毒（HPV）紧随其后。HPV导致了100%的宫颈癌病例，以及肛门癌、外阴癌、阴道癌、阴茎癌和部分头颈部癌症，在全球范围内导致了近75万例新发病例，在撒哈拉以南非洲地区发病率较高。乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）也与大量肝癌病例有关。研究人员首次将更多的癌症与感染联系起来，将名单扩大到了另外16种癌症。

Gary Clifford, a cancer epidemiologist and study co-author based in Lyon, France, said the science has advanced significantly. “There’s been new infectious agents identified in this time as being cancer-causing, and even the infectious agents that we knew about in the past, the evidence has increased about the number of different cancers that they can cause,” he said. Some of those new infectious agents included HIV and its link to cervical cancer, and a very rare virus called Merkel cell polyomavirus that can lead to an aggressive form of skin cancer. 常驻法国里昂的癌症流行病学家、该研究的合著者加里·克利福德（Gary Clifford）表示，科学已经取得了重大进展。他说：“在此期间，人们发现了新的致癌感染源，即使是过去已知的感染源，关于它们能引起多少种不同癌症的证据也增加了。”其中一些新的感染源包括艾滋病毒（HIV）及其与宫颈癌的联系，以及一种名为默克尔细胞多瘤病毒（Merkel cell polyomavirus）的罕见病毒，它可能导致一种侵袭性皮肤癌。

To come up with numbers, researchers first examined which infections cause cancer, then calculated what fraction of these cancers can be linked to specific infections and applied those calculations to global databases of new cancer cases. 为了得出这些数据，研究人员首先调查了哪些感染会导致癌症，然后计算了这些癌症中有多少比例可以与特定感染联系起来，并将这些计算结果应用于全球新发癌症病例数据库。

Another significant shift is the recognition of the role of Epstein-Barr virus (EBV). EBV was linked to about 260,000 cases globally in 2024, and can lead to nasopharyngeal cancer, some gastric cancers and Hodgkin’s lymphoma. “That’s quite a big burden of cancer caused by Epstein-Barr virus that was not counted in the past, but is now recognized,” Clifford said. Epstein-Barr virus is also a key risk factor in developing multiple sclerosis, and unlike some of the other infections that have vaccines or antibiotic treatments, there are no available tools to fight against it. 另一个重大转变是对EB病毒（Epstein-Barr virus, EBV）作用的认识。2024年，全球约有26万例病例与EBV有关，它可导致鼻咽癌、部分胃癌和霍奇金淋巴瘤。克利福德说：“这是EB病毒造成的相当大的癌症负担，过去未被计入，但现在得到了认可。”EB病毒也是导致多发性硬化症的关键风险因素，与其他有疫苗或抗生素治疗的感染不同，目前还没有对抗它的有效工具。

“The fact that we’re seeing Epstein-Barr has caused all these chronic diseases — it’s increasingly becoming a target that people need to focus on for prevention,” he said. The global report highlights vast regional differences, mostly driven by historical disparities, researchers said. High-income countries that established cancer screening and vaccination programs over the last few decades are doing much better compared to lower- and medium-resourced countries where access to prevention and treatment is limited. 他说：“我们看到EB病毒导致了所有这些慢性疾病，它正日益成为人们需要重点预防的目标。”研究人员表示，这份全球报告强调了巨大的地区差异，这主要是由历史差距造成的。在过去几十年里建立了癌症筛查和疫苗接种计划的高收入国家，其表现远好于预防和治疗资源有限的中低收入国家。

“We really still have a lot of work to do implementing things that we know work and we’ve known for a long time but haven’t really made it into all populations in the world,” Clifford said. In North America, the burden of cancer-causing infections is much lower, but H. pylori and HPV are the most common sources. 克利福德说：“在实施我们已知有效且早已知晓，但尚未真正惠及全球所有人群的措施方面，我们确实还有很多工作要做。”在北美，由感染引起的癌症负担要低得多，但幽门螺杆菌和HPV仍是最常见的来源。

In Canada, according to a 2019 study, the rate of cancers attributable to infections was estimated to be at four per cent. Karena Volesky, an epidemiologist in Montreal, led the Canadian research team while at McGill University. “It tells us how important each of the 12 infections are,” Volesky said of the new global numbers. While there is a lower prevalence of these forms of infections in Canada, her study estimated… 在加拿大，根据2019年的一项研究，由感染引起的癌症比例估计为4%。蒙特利尔的流行病学家卡琳娜·沃莱斯基（Karena Volesky）在麦吉尔大学任职期间领导了加拿大研究团队。谈到新的全球数据时，沃莱斯基说：“这告诉我们这12种感染中的每一种有多重要。”虽然这些感染在加拿大的流行率较低，但她的研究估计……