Infection-driven cancers in Asia: implications from epidemiological transitions.

Abstract

Gastric, liver, and cervical cancers account for a disproportionate share of the global cancer burden, particularly in Asia, where infection-related cancers remain a major public health challenge. This narrative review aims to provide an overview of the epidemiological transition of these cancers and their implications for cancer control in Asia. Updated population-attributable fractions and other epidemiological evidence indicate a declining contribution of infections to overall cancer incidence, reflecting ongoing epidemiological transitions. While prevention of infection-driven cancers in Asia requires pathogen-specific strategies, they should be adapted to the changing epidemiological patterns. Population-wide <i>Helicobacter pylori</i> eradication combined with risk-stratified screening represents an effective strategy to reduce gastric cancer burden. Liver cancer prevention increasingly requires tackling viral and emerging metabolic risk factors. HPV- and HBV-related cancers are largely preventable through vaccination, although coverage remains uneven across Asia. EBV contributes substantially to nasopharyngeal cancer burden in East and Southeast Asia, highlighting persistent geographic disparities. Given substantial heterogeneity in the prevalence of major infectious agents and health-system capacity across countries, effective prevention strategies should be tailored to country-specific contexts, balancing benefits, risks, and cost-effectiveness. With equitable access to vaccination, antimicrobial therapy, and targeted screening, substantial reductions in infection-related cancer burden in Asia may be achievable.