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Burden and Correlates of Multiple Chronic Infections and Their Associations With Cancer Incidence in Chinese Adults: A Large Case-Cohort Study.
Yang, L. ; Clarke, J. ; Kröller, L.DKFZ* ; Kartsonaki, C. ; Fry, H. ; Jeske, R.DKFZ* ; Gordon, A. ; Clark, S. ; Hill, M. ; Avery, D. ; Chen, Y. ; Du, H. ; Lv, J. ; Sun, D. ; Yu, C. ; Li, L. ; Millwood, I. Y. ; Waterboer, T.DKFZ* ; Chen, Z. ; Group, C. K. B. C. (Collaboration Author) ; Chen, J. (Contributor) ; Chen, Z. (Contributor) ; Clarke, R. (Contributor) ; Collins, R. (Contributor) ; Li, L. (Contributor) ; Lv, J. (Contributor) ; Peto, R. (Contributor) ; Walters, R. (Contributor) ; Li, L. (Contributor) ; Lv, J. (Contributor) ; Yu, C. (Contributor) ; Sun, D. (Contributor) ; Pang, Y. (Contributor) ; Han, Y. (Contributor) ; Hou, C. (Contributor) ; Xia, Q. (Contributor) ; Liu, C. (Contributor) ; Pei, P. (Contributor) ; Pan, L. (Contributor) ; Han, X. (Contributor) ; Bian, H. (Contributor) ; Chen, X. (Contributor) ; Avery, D. (Contributor) ; Barnard, M. (Contributor) ; Bennett, D. (Contributor) ; Boxall, R. (Contributor) ; Chen, Y. (Contributor) ; Chen, Z. (Contributor) ; Clarke, J. (Contributor) ; Clarke, R. (Contributor) ; Du, H. (Contributor) ; Mohamed, A. E. (Contributor) ; Fry, H. (Contributor) ; Harish, P. (Contributor) ; Im, P. K. (Contributor) ; Iona, A. (Contributor) ; Kartsonaki, C. (Contributor) ; Kolhe, K. (Contributor) ; Lam, H. (Contributor) ; Lin, K. (Contributor) ; Liu, J. (Contributor) ; Millwood, I. (Contributor) ; Morris, S. (Contributor) ; Nie, Q. (Contributor) ; Pozarickij, A. (Contributor) ; Rahmati, M. (Contributor) ; Ryder, P. (Contributor) ; Sarder, M. (Contributor) ; Schmidt, D. (Contributor) ; Stevens, B. (Contributor) ; Turnbull, I. (Contributor) ; Walters, R. (Contributor) ; Wang, B. (Contributor) ; Wang, L. (Contributor) ; Wright, N. (Contributor) ; Yang, L. (Contributor) ; Yang, X. (Contributor) ; Yao, P. (Contributor) ; Pang, Z. (Contributor) ; Gao, R. (Contributor) ; Lv, K. (Contributor) ; Li, S. (Contributor) ; Duan, H. (Contributor) ; Wang, S. (Contributor) ; Liu, Y. (Contributor) ; Du, R. (Contributor) ; Cheng, L. (Contributor) ; Tian, X. (Contributor) ; Zhang, H. (Contributor) ; Hu, D. (Contributor) ; Zheng, X. (Contributor) ; Wang, Y. (Contributor) ; Sun, W. (Contributor) ; Yan, S. (Contributor) ; Wang, C. (Contributor) ; Wu, Z. (Contributor) ; Zhai, L. (Contributor) ; Pang, Z. (Contributor) ; Dong, S. (Contributor) ; Liu, L. (Contributor) ; Yin, D. (Contributor) ; He, B. (Contributor) ; Liu, Y. (Contributor) ; Wang, X. (Contributor) ; Ou, T. (Contributor) ; Zheng, X. (Contributor) ; Zheng, D. (Contributor) ; Yang, S. (Contributor) ; Li, L. (Contributor) ; Chen, X. (Contributor) ; Xu, Y. (Contributor) ; Zhou, J. (Contributor) ; Tao, R. (Contributor) ; Su, J. (Contributor) ; Fan, X. (Contributor) ; Chen, X. (Contributor) ; Huang, Y. (Contributor) ; Lu, Y. (Contributor) ; Hua, Y. (Contributor) ; Xing, L. (Contributor) ; Wang, S. (Contributor) ; Jin, J. (Contributor) ; Ma, J. (Contributor) ; Liu, J. (Contributor) ; Zhu, K. (Contributor) ; Ren, H. (Contributor) ; Shen, X. (Contributor) ; Zhong, G. (Contributor) ; Mao, W. (Contributor) ; Lu, Z. (Contributor) ; Zhong, Y. (Contributor) ; Zhou, L. (Contributor) ; Pan, R. (Contributor) ; Lan, J. (Contributor) ; Tan, X. (Contributor) ; Tan, J. (Contributor) ; Xie, Y. (Contributor) ; Wei, L. (Contributor) ; Zhou, L. (Contributor) ; Wang, S. (Contributor) ; Wu, X. (Contributor) ; Zhang, N. (Contributor) ; Chen, X. (Contributor) ; Chang, X. (Contributor) ; Wang, Z. (Contributor) ; He, Y. (Contributor) ; Yuan, M. (Contributor) ; Wang, L. (Contributor) ; Chen, X. (Contributor) ; Wang, Z. (Contributor) ; Sun, Q. (Contributor) ; Lin, Y. (Contributor) ; Chen, F. (Contributor) ; Ren, X. (Contributor) ; Chang, L. (Contributor) ; Zhong, F. (Contributor) ; Feng, J. (Contributor) ; Hu, W. (Contributor) ; Zhang, X. (Contributor) ; Chen, Y. (Contributor) ; Wang, H. (Contributor) ; Wang, J. (Contributor) ; Diao, L. (Contributor) ; Han, Z. (Contributor) ; Zhu, D. (Contributor) ; Kang, K. (Contributor) ; Feng, S. (Contributor) ; Yang, W. (Contributor) ; Tian, H. (Contributor) ; Yan, Y. (Contributor) ; Han, B. (Contributor) ; Gao, L. (Contributor) ; Li, S. (Contributor) ; Xing, T. (Contributor) ; Tang, W. (Contributor) ; Li, X. (Contributor) ; Sun, H. (Contributor) ; Zhao, X. (Contributor) ; Li, Y. (Contributor) ; Hu, C. (Contributor) ; He, P. (Contributor) ; Zhang, X. (Contributor) ; Jin, Y. (Contributor) ; Luo, L. (Contributor) ; Yu, M. (Contributor) ; Hu, R. (Contributor) ; Wang, H. (Contributor) ; Gong, W. (Contributor) ; Zhong, J. (Contributor) ; Wang, M. (Contributor) ; Xu, C. (Contributor) ; Gong, K. (Contributor) ; Xu, H. (Contributor) ; Cao, Y. (Contributor) ; Xie, K. (Contributor) ; Chen, L. (Contributor) ; Tu, X. (Contributor) ; Pan, J. (Contributor) ; Li, X. (Contributor) ; Yin, L. (Contributor) ; Liu, H. (Contributor) ; Liu, Y. (Contributor) ; Yin, L. (Contributor) ; Xie, X. (Contributor) ; Wang, J. (Contributor) ; Xiao, B. (Contributor) ; Deng, Z. (Contributor) ; Peng, Y. (Contributor) ; Zhang, L. (Contributor) ; Qu, C. (Contributor) ; Deng, L. (Contributor) ; Jiang, Q. (Contributor) ; Chen, Y. (Contributor)
2026
Wiley-Liss
Bognor Regis
Abstract: Several oncogenic pathogens cause specific cancers, but uncertainties remain about many other chronic infections, combined pathogen effects and evidence from non-European populations. We conducted a case-cohort study of ~30,000 site-specific incident cancer cases and > 8000 subcohort participants nested within the China Kadoorie Biobank. Baseline plasma was assayed for IgG antibodies against 47 antigens from 20 pathogens (16 viruses, 3 bacteria, 1 parasite) using an Automated Multiplex Serology assay. We described seroprevalence by age, sex, areas and lifestyle factors; estimated adjusted odd ratios for correlates of pathogen seropositivity in the subcohort using multivariable logistic regression and adjusted hazard ratios for overall and selected cancers using Prentice-weighted Cox models. Among subcohort participants, seroprevalence for most pathogens varied and was significantly associated with sex, region and birth cohort. Participants were seropositive for a mean of ~10 pathogens. Compared with seronegative participants, those seropositive for seven pathogens had significantly higher overall cancer risk, particularly for HCV (HR = 2.18, 95% CI: 1.90-2.49), CMV (1.23, 1.08-1.40) and HSV-2 (1.14, 1.09-1.18) and HPV-16 oncogenes (e.g., E6: 1.57, 1.40-1.75). Lower risks were observed for HSV-1 (0.88, 0.81-0.95) and among those with fewer co-infections. There were expected positive associations of liver cancer with HBV (2.29, 2.06-2.54) and HCV (7.05, 4.31-11.54) and of stomach cancer with H. pylori (1.91, 1.68-2.17). In Chinese adults, multiple chronic infections were associated with risk of overall and certain selected cancers. Further research is warranted to investigate pathogen-specific and co-infection-related risks of site-specific cancers.
Keyword(s): automated multiplex serology ; cancer ; chronic infection ; prospective study ; relative risk
Note: epub
Contributing Institute(s):
- Infektionen und Krebsepidemiologie (C230)
Research Program(s):
- 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)
Appears in the scientific report
2026
Database coverage:
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; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; DEAL Wiley ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz
; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
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