Risk assessmentindependent cross-checkabstract only checked I-CAN-05 standard review
Infections cause about 2.2 million cancers a year worldwide
Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis.
Overview
de Martel C et al.. Lancet Glob Health 2020 · PMID 31862245 · DOI 10.1016/S2214-109X(19)30488-7
H. pylori, HPV and hepatitis B/C viruses cause most infection-related cancers.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Estimate infection-related cancer.
- How was the study done?
PAF.
- How many people, animals or samples were studied?
Global.
- What was actually found?
2.2 million cases.
- How large was the observed effect?
ASIR 25/100,000.
- What do the results mean in everyday life?
Vaccination (HBV, HPV) and treatment of infections prevent cancer.
- What are the study's limitations?
Modelling.
- What does it say about Elawady's specific claim?
Not all cancer is food-related.
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Individual cause.
Scientific in-depth review
1. Full reference
- Authors
- de Martel C et al.
- Journal
- Lancet Glob Health
- Year
- 2020
- Identifier
- PMID 31862245 DOI 10.1016/S2214-109X(19)30488-7
- Verification
- verified – PubMed esummary + efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Funding: IARC
2. Research question
Infection-attributable cancer burden.
3. Study design and population
- Study design
- Risk assessment – Global attributable-fraction analysis (GLOBOCAN 2018)
- Population
Global
- Country
Global
- Period
2018
- Sample size
Global
- Inclusion and exclusion criteria
10 carcinogenic pathogens
4. Methods and endpoints
- Exposure / intervention
Infections (H. pylori, HPV, HBV, HCV etc.)
- Endpoints
Infection-attributable cancer cases
- Statistical methods
PAF
5. Actual results
- Results
2.2 million infection-attributable cancers in 2018 (ASIR 25.0/100,000); H. pylori 810,000, HPV 690,000, HBV 360,000, HCV 160,000.
- Absolute risks
2.2 million cases in 2018
- Authors' conclusion
Infection-targeted prevention can markedly reduce cancer burden.
6. Strengths
- Global coverage
7. Weaknesses
- Model-based fractions
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Modelling.
9. Assessment of the statistical interpretation
Infections are a major, food-independent cause (especially relevant to Egypt via HCV/HBV - liver cancer).
10. Relevance to the specific claim
Infections as non-dietary cause.
11. Independent contrary findings
12. Transferability to Germany and Europe
High; relevant to Egypt.
13. Overall methodological judgement
Context.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- Cancer is the body's own plan ('a self plan'): body cells are ordered to transform because this was necessary for the person's life; it is not caused by external agents. – Studies contradicting or limiting the claim
- Chronic disease is mostly a cumulative reaction to what enters the body daily - contaminated food, medicines and cosmetics - not a fate that comes from outside. – Studies contradicting or limiting the claim