Overall, China, South Korea, Japan, and Mongolia have suffered the most!Why are East Asians so unlucky?Over the past sixty years, people have made a series of breakthroughs in understanding the link between infection and cancer, and at the same time, the prospects for preventing cancer have become increasingly broad.Many carcinogenic infections are potential modifiable risk factors, and the medical community has developed corresponding prevention tools for this.Of the 11 infectious pathogens classified by the International Agency for Research on Cancer (IARC) as first-class carcinogens, the most important four are Helicobacter pylori (Hp), high-risk human papilloma virus (HPV), and hepatitis B virus (HBV) and hepatitis C virus (HCV).Taken together, they account for more than 90% of infection-related cancers worldwide.Recently, by using relevant histological subtypes from the Cancer Registry and using GLOBOCAN (the IARC online database provides estimates of morbidity and mortality for 36 cancers in 185 countries), IARC researchers estimated the 2018 national levelThe incidence of cancer attributable to infection.Related research results were published in The Lancet Global Health (Impact Factor 15.873).Of the 2.2 million new infection-related cancer cases, more than 90% can be attributed to Hp, HPV, HBV, and HCV. As shown in Tables 1 and 2, as a whole, in 2018, there were 2.2 million new cancer cases worldwide.Attributable to infection, accounting for 13% of all cancer cases (excluding non-melanoma skin cancer); the age-standardized incidence (ASIR) was 25.0 cases per 100,000 person-years.More than 90% of them can be attributed to Hp, HPV, HBV, and HCV: Hp caused 810,000 new cases, mainly non-cardia gastric adenocarcinoma, and ASIR was 8.7 cases per 100,000 person-years; HPV caused 690,000 new cases, mainlyIt is cervical cancer, with an ASIR of 8.0 cases per 100,000 person-years; HBV causing 360,000 new cases, and ASIR of 4.1 cases per 100,000 person-years; HCV causing 160,000 new cases, mainly hepatocellular carcinoma, and ASIR per 1010,000 cases per 10,000 people.Other infectious pathogens, namely Epstein-Barr virus (Human Herpesvirus 4, HHV-4), Human T-lymphotropic virus type I (HTLV-1), Human Herpesvirus 8 (Kaposi’s sarcoma herpes virus, HHV-8)) And parasite infections caused the remaining 210,000 new cases.The total burden of cancer attributable to infection is equal between men and women, but the lineage of infectious pathogens and cancer varies by gender; as shown in Table 1.East Asia suffers the most. China is the most attributable. Attributable infections are estimated to be the highest in East Asia, with ASIR at 37.9 cases per 100,000 person-years, followed by Sub-Saharan Africa (33.1 cases per 100,000 person-years), Northern Europe (every 1013.6 cases per 10,000 person-years) and West Asia (13.8 cases per 100,000 person-years) were the lowest; as shown in Table 2.However, the relative contribution of the four major infectious pathogens to cancer incidence varies by region.In East Asia, the burden of cancer attributable to infection mainly comes from Hp (17.6 cases per 100,000 person-years) and HBV (10.5 cases per 100,000 person-years).It is worth noting that of the 2.2 million new cancer cases attributable to infection worldwide in 2018, China alone accounted for 780,000 (35%); including 340,000 (42%) HpAs a result, 250,000 cases (69%) were caused by HBV; as shown in Table 2.The high cancer burden in China is not only caused by a large population, but also by high ASIR attributable to Hp (15.6 cases per 100,000 person-years) and high ASIR attributable to HBV infection (11.7 cases per 100,000 person-years).) Caused jointly; as shown in Table 2 and Figure 1.The situation in the three Koreas, Japan, and the United States is also not good. Mongolia ’s severely exceeded standards can be attributed to Hp cancer at high risk areas including East Asia, Latin America (especially its west coast), the Middle East and Eastern Europe; as shown in Figure 1.High-risk areas of cancer attributable to HBV are clustered in certain countries in East Asia and West Africa.Specifically, the incidence of cancer caused by H. pylori infection is very high in South Korea, with ASIR at 35.2 cases per 100,000 person-years, followed by Japan (23.8 cases per 100,000 person-years); in addition, cancers attributable to HBVThe incidence is also high in South Korea (8.6 cases per 100,000 person-years).In all other regions, ASIR caused by Hp infection is less than 10 cases per 100,000 person-years (the highest in Central and Eastern Europe, 9.2 cases per 100,000 person-years); ASIR caused by HBV is less than 3 cases per 100,000 persons (except Southeast Asia,5.8 cases per 100,000 person-years).The high burden of cancer attributable to infections in sub-Saharan Africa is mainly caused by cancers caused by HPV (19.3 cases per 100,000 person-years).Among all regions of the world, this region has the highest ASIR for HPV-related cancers; as shown in Figure 2.This area also has the highest ASIR for cancers associated with human herpes virus type 8.Other regions with a particularly high burden of cancer caused by HPV include Central and Eastern Europe (10.9 cases per 100,000 person-years), Southeast Asia (9.6 cases per 100,000 person-years), South America (9.6 cases per 100,000 person-years), and India (per 100,000 person-years)9.0 cases per 100,000 people).Except for the Middle East, the ASIR of HPV-related cancers in most countries and regions is higher than 5 cases per 100,000 people; as shown in Figure 1.There is a clear correlation between ASIR for cancer attributable to HPV and national income measured by the World Bank, from 6.9 cases per 100,000 people-years in high (and middle-high) income countries to 109.2 cases per 10,000 person-years, and 16.1 cases per 100,000 person-years in low-income countries.In all regions, cancers attributable to HPV dominate the female population, while cancers attributable to other infections are more common in men than in women.ASIR for cancer attributable to HCV is highest in North Africa (12.0 cases per 100,000 person-years), and below 5 cases per 100,000 person-years in all other regions of the world; as shown in Table 2.Two high-income countries, Japan (4.1 cases per 100,000 person-years) and the United States (3.6 cases per 100,000-years), have a higher incidence of cancer attributable to HCV than the world average (1.7 cases per 100,000-years);As shown in table 2.Of the four major infectious pathogens, Mongolia is the only country with ASIRs in the highest category (greater than 10 cases per 100,000 person-years).Both men and women are affected by HPV. Cervical cancer accounts for about 80% of the cancer burden attributable to HPV, and women (620,000 cases) account for about 90% of worldwide cancer attributable to HPV (690,000 cases); as shown in the table1 is shown.However, these ratios vary by income category, with the highest rates in low-income countries; as shown in Figure 3.Conversely, in high-income countries, the proportion of anal reproduction and head and neck cancer burden caused by HPV is higher than in low-income countries, as is the proportion of men’s cancer attributable to HPV.Overall, HPV 16 and HPV 18 accounted for 72% (500,000 cases) of all cancer cases attributable to HPV, and HPV 31, HPV 33, HPV 45, HPV 52, and HPV 58 accounted for 17% (12Million cases); as shown in Figure 3.Wu Ling’s pain in the heart, what should I do?Since cancers caused by Hp, HPV, HBV and HCV infections have placed a heavy burden on East Asian countries (especially China), the following points must be achieved in terms of prevention and control measures.▍ Vaccination: Hepatitis B vaccine and HPV vaccine are the only two vaccines in the world that can effectively prevent cancer.Since the infancy of hepatitis B vaccine and other measures have been carried out, the number of hepatitis B virus carriers in China has decreased, and the incidence of liver cancer has also decreased.The launch of cervical cancer vaccines also brings hope to vulnerable populations.▍ Pay attention to diet hygiene Hp is highly contagious and can be transmitted through hands, dirty food or tableware, feces and other channels.Therefore, people should develop good eating and drinking habits in daily life.Use public chopsticks and spoons for dinner, and share meals when possible; patients with chronic gastritis should avoid mouth-to-mouth feeding of young children; patients should not kiss with others.▍ Timely treatment It is important to take reasonable antiviral treatment and prevent liver cirrhosis for chronic hepatitis B, which can effectively control and delay the onset of liver cirrhosis and liver cancer.Early treatment of precancerous lesions of gastric and cervical cancer can effectively reduce the incidence of cancer.定期 Regular screening of high-risk populations Those who are infected with HBV, HCV, HPV, EB virus, and Hp are regarded as high-risk populations for corresponding cancers. They should conduct regular physical examinations to detect early cancers early and achieve the goals of early diagnosis and early treatment.The above content is only authorized by 39Health.com for exclusive use, please do not reprint without authorization of the copyright party..
Infected with cancer, China has become a “heavy disaster area”!