Cancer Prevention; Emerging Infectious Diseases as Risk Factors, Iran Feature

In the previous issue I had a short note about cancer prevention and infectious diseases, discussing the regional feature in the EMRO countries. The infectious agents play a role of 26% in developing countries as the causes of malignancies. In Iran there is no specific data about the rate of infections as the main cause of cancers but due to available data the relation of infectious agents and cancers are clear which demonstrate how much is important to discuss. For example the mean rate of infection with HPV (Human Papiloma Virus) in normal population is around 10% and in cervical cancer patients is between 40%-90% in different studies which is lower than other developing countries that may be due to community behavior based on Islamic rules. 95% of nasopharyngeal cancer patients are infected by EBV (Epstein Barr Virus) and 65% of cases with gastric cancer are affected by HP (Helicobacter Pylori) which is not so far from normal population infection (60%). Prevalence of infection by HBV (Hepatitis B Virus) in Iran is less than 3% for youth and less than 40% for adult, this is because of community based vaccination integrated to national program which is most cost effective project against cancer. This rate in the EMRO countries is around 86%. It is well recognized that younger children infected by these agents have much higher rates of chronic persistent infection and reasonably more cancer involvement. Madam Brundtland in position of Director General of World Health Organization reported (2002) that: "2/3 as all disease in later life can be traced back to behavior patterns established during teenage years as to exposure to health threatening environments in childhood" Accepting this important idea, guide us to know how and when should be intervention to control the infectious diseases related to cancer as a part of Comprehensive Cancer Control Program.