Does Infectious Diseases Control and Cancer Go Hand in Hand?
Updated: 8 hours ago
Authored by: Venkat Rao
When I tried to dig up published literature to find the health benefits of infection prevention and control, I found mostly the sort of widely prevalent narratives such as better infection control leads to protection of vulnerable patients; reduction in healthcare facility-related infections; lower infection rates; enhance staff and visitor safety; more effectively combat antibiotic resistance; and several other community-level public health benefits.
But one striking new finding introduces a new dimension to failure in infectious disease control, among others, with increase in cancer incidence. Yes, a recent report finds more than 2.3 million new cancer cases linked to infections accounting for nearly 12% of all cancer cases in 2024 alone, implicating a staggering cumulative burden of cancer cases linked to ineffective control and management of infectious diseases.
The study published in this month volume of The Lancet Oncology journal, examines the global burden of cancers attributable to infectious diseases in 2024. Using the data from the Global Cancer Observatory’s Cancer Today (GLOBOCAN) database, researchers estimated 2.3 million new cancer cases attributable to 12 infectious disease agents in 2024. A combined total of 2.3 million cancer incidence were attributed to five viral infectious diseases, accounting for 12% of all cancer cases reported globally in the GLOBOCAN database. Researchers project the global cancer burden grow from 20 million new cases in 2024, to 35 million in 2050, implicating the significant negative impact from infectious diseases, and the crucial need for investments in infection control and prevention. Infectious agents are a preventable cause for cancer and is a disproportionate risk factor for cancer among women in 141 countries and men in 58 countries.
Some virus and bacteria as the causative agent for cancer is a well-established fact. Virus as a biological agent is classified as a Class I carcinogen by the International Agency for Research on Cancer (IARC). Let us not assess the gravity of the cancer burden from the intrinsic hazard-based classification of some viruses as Class I carcinogens. Instead, let us examine the disease burden involving the 12 viruses with strong links to cancer, which in most cases are preventable through better infection control practices.
To illustrate with a few examples on the scale of global burden of infectious diseases linked to the 12 Class I carcinogenic viruses, an estimated 4.4 billion people are infected with Helicobacter pylori, making it the most common chronic bacterial infection worldwide. H pylori, is the only bacterial pathogen classified as a Class I human carcinogen, which accounts for an estimated 80%–90% of gastric cancers globally.
Moving on to Hepatitis B, US Centers for Disease Control and Prevention estimates 240 to 300 million people in the world with chronic hepatitis B virus infection, which accounts for over 3% of the global population with annual fatalities around 1.1 million primarily due to complications in liver such as cirrhosis and hepatocellular cancer.
WHO estimates 47 million individuals carrying chronic hepatitis C infection and an estimated 900,000 new infections occurring per year adding to the global disease burden.
The most salient observation from the recent The Lancet Oncology report is not that certain virus are causative agents of cancer, which is well documented in the scientific literature. It is the linkage between infection control practices, or their lack thereof, with increased cancer incidence, which brings infection control as not merely a health and hygiene issue in the public health realm, but under an entirely new risk of carcinogenesis and related health security perspective. In my assessment, a more rigorous review of disease surveillance literature will find poor/inadequate infection control practices and infectious diseases contributing to more than 12% of the global cancer burden as reported in the recent study.
Most developing nations are less rigorous about infection control practices primarily due to lack of resources, training and awareness on their adverse impact on public health. As a result, the largest burden of infection-attributable cancer, measured as age-adjusted infection rate, is in the East Asian region with over 900,000 cases, accounting for 42% of the global total. The other region with a higher than global average is the sub-Saharan Africa, followed by Southeast Asia.
There is a large body of evidence in the published public health research linking certain types of viral infections with long term risk of cancer and developmental disorders, which is not the subject of this article. Noteworthy is the link between infection control and increase in cancer cases offering a unique perspective from the health security and cancer risk assessment standpoint.
Lack of rigorous infection control practices, a widely prevalent global health and hygiene problem at places such as workplace, hospitals, schools, day care centers, offices, public transportation, nursing homes, college campuses, and cruise ships may contribute to increase risk of cancer in the general population the scope and magnitude of which is unclear. A prudent measure calls for a more rigorous health and environmental protection. These measures should focus on better communication to the general public on the potential risk of cancer as an adverse outcome from poor infection control practices in public places and lower the public health infectious diseases burden and the risk of preventable cancer as well.
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