INFECTION-ATTRIBUTABLE cancer caused 2.3 million cases globally in 2024, representing twelve percent of all diagnosed malignancies. A comprehensive worldwide analysis evaluating twelve oncogenic pathogens established that infectious agents remain a major preventable cause of cancer morbidity. While overall global age-standardized incidence reached 22.7 cases per 100,000 person-years, low-income and middle-income regions bore more than three-quarters of the entire disease burden. Eastern Asia recorded the largest absolute caseload with 990,000 cases, while sub-Saharan Africa demonstrated the highest proportional impact, where pathogens drove a quarter of all diagnosed malignancies.
Two primary pathogens drove nearly two-thirds of the total infectious oncologic burden. Helicobacter pylori accounted for 760,000 cases, primarily causing non-cardia gastric adenocarcinoma and related gastrointestinal cancer sequelae. Human papillomavirus followed closely with 750,000 cases, responsible for all 600,000 cases of cervical cancer alongside substantial fractions of anal, penile, vulvar, vaginal, and oropharyngeal malignancies. Hepatitis B virus contributed 360,000 cases, predominantly hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Epstein-Barr virus generated 260,000 cases, emerging as the fourth leading pathogen due to established links with nasopharyngeal carcinoma, gastric adenocarcinoma, and diverse lymphoma subtypes. Hepatitis C virus generated 160,000 malignancies. Additional oncogenic agents included Kaposi sarcoma-associated herpesvirus, human T-cell lymphotropic virus type 1, Merkel cell polyomavirus, Schistosoma haematobium, liver flukes, and HIV.
Managing infection-attributable cancer requires aggressive primary prevention alongside expanded diagnostic screening across primary care systems. Proven tools such as routine immunization against human papillomavirus and hepatitis B yield substantial risk reductions when widely implemented. Early detection of gastric precursors through screen-and-treat protocols for bacterial infection offers measurable clinical efficacy, mirroring successful endoscopic protocols in East Asia. Expanding access to direct-acting antivirals for viral hepatitis, promoting barrier protection, and providing long-acting pre-exposure prophylaxis for populations vulnerable to retroviral transmission further curb oncogenic progression. Clinicians must maintain heightened vigilance regarding oncogenic infectious etiologies, integrating vaccination status reviews and targeted pathogen screening into standard preventive adult care.
Reference
Rumgay H et al. Global burden of cancer attributable to infections in 2024: a worldwide incidence analysis. Lancet Oncol. 2026;27:1237-48.
arcyto on adobe stock
Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.
