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Table 1 Principal oncogenic agents and their participation to associated cancers

From: Infections and cancer: the “fifty shades of immunity” hypothesis

Oncogenic agents Associated cancer Contribution Transmission Prevention or elimination methods Carcinogens classification Ref
Macro-Parasites       [90, 91]
Schistosoma haematobium Bladder cancer 30% Water Anti-helminthics   
Opisthorchis viverrini and Clonorchis sinensis Cholangioma liver cancer 15% Food Anti-helminthics   
Helicobacter pylori Stomach cancer 80% Water, sanitation, food, saliva Antibiotics, sanitation Indirect [92, 93]
Viruses       [92, 94, 95]
 Epstein Barr Virus Burkitt’s lymphoma, nasoparyngeal cancer 10–30% Saliva Antivirals for some illnesses   
 Hepatitis B and C Liver cancer 80% needles, sex Vaccination (HBV), antivirals, blood screening   
 Human T lymphotropic virus Adult T cell leukaemia Almost 100% Sex, needle, milk No treatment Direct and indirect  
 Human Papillomavirus Cervical cancer 100% Sex, saliva Vaccination, pap smear   
 Human Herpesvirus 8 Kaposi sarcoma Almost 100% Sex, saliva No treatment   
 Merkel cell polyomavirus Merkel cell cancer Almost 100% Saliva No treatment   
  1. Today, the World Health Organization acknowledges that at least 20% of cancers have an infectious origin [96]. For transmission section, “needles” includes blood transfusion, contaminated medical syringes and illicit intravenous drug use. A classification of oncogenic organisms has been proposed on the basis of their contribution to carcinogenesis [1]. When infection leads to introduction of viral oncogenes into the host genome, pathogens are considered to be direct carcinogens. These pathogens exploit the host in ways that interfere with mechanisms of cancer prevention (cell cycle arrest, apoptosis, restriction of telomerase and cell adhesion). Infectious organisms that induce immunosuppression, chronic inflammation and/or chromosomal instability, are referred to as indirect carcinogens as they may drive mutations and promote cancer cell proliferation