Racial/Ethnic Differences in Cancers Attributable to Preventable Infectious Agents in Texas, 2015

• Published in: Public health reports (1974) 2020-11, Vol.135 (6), p.805-812
• Main Authors: Gudenkauf, Franciska J., Thrift, Aaron P.
• Format: Article
• Language: English
• Subjects: Adult; Adults; Aged; Cancer; Carcinogens; Epidemiology; Ethnic groups; Ethnic Groups - statistics & numerical data; Ethnicity; Female; Helicobacter Infections - complications; Helicobacter pylori; Hepatitis; Hepatitis B; Hepatitis C; Hispanic Americans; Human papillomavirus; Humans; Infections; Male; Middle Aged; Minority & ethnic groups; Minority groups; Minority Groups - statistics & numerical data; Neoplasms - ethnology; Neoplasms - etiology; Nutrition; Nutrition Surveys; Prevention; Racial differences; Risk assessment; Texas - epidemiology; Virus Diseases - complications; Viruses
• ISSN: 0033-3549; 1468-2877
• DOI: 10.1177/0033354920954497

Objective The International Agency for Research on Cancer has classified 13 infectious agents as carcinogenic or probably carcinogenic to humans. We aimed to estimate the percentage (ie, population-attributable fraction) and number of incident cancer cases in Texas in 2015 that were attributable to oncogenic infections, overall and by race/ethnicity. Methods We calculated population-attributable fractions for cancers attributable to human papillomavirus (HPV), Helicobacter pylori, hepatitis C virus (HCV), hepatitis B virus (HBV), and human herpesvirus 8 (HHV-8) infections using prevalence estimates from National Health and Nutrition Examination Survey laboratory data and relative risks associated with infection from previous epidemiological studies. The Texas Cancer Registry provided cancer incidence data. Results We estimated that 3603 excess cancer cases, or 3.5% of all cancers diagnosed in 2015, among adults aged ≥25 in Texas were attributable to oncogenic infections. Hispanic adults had the highest proportion of cancer cases attributable to infections (5.6%), followed by non-Hispanic Black (5.4%) and non-Hispanic White (2.3%) adults. HPV infection caused the highest proportion of all cancer cases (1.8%) compared with other oncogenic infections (HCV, 0.8%; H pylori, 0.5%; HBV, 0.3%; HHV-8, 0.1%). Hispanic adults had the highest proportions of all cancers caused by HPV infection (2.6%) and H pylori (1.1%), and non-Hispanic Black adults had the highest proportions of all cancers caused by HCV infection (1.7%), HBV infection (0.7%), and HHV-8 (0.3%). Conclusion Preventable oncogenic infections contribute to cancer incidence in Texas and may affect racial/ethnic minority groups disproportionately. Infection control and prevention should be stressed as an important component of cancer prevention.