Infections and cancer - greater risk in Philippines than UK

[Doc Alan]

We know that avoidable “ lifestyle choices “ ( smoking, diet, excess weight and alcohol ) are linked to at least 2 in 5 cancers. Both in Philippines and UK cancers are second only to cardiovascular diseases as causes of death.
It’s less well known that around one in six cancers worldwide, nearly a third of these in people under 50 years of age, are caused by infections. This has been confirmed in a recent study ( The Lancet medical journal … http://www.thelancet.com/journals/lancet/article/PIIS1470-2045(12)70137-7/fulltext ).

Cancer development is complex, requiring multiple steps, probably over many years. Proving that one ( or more ) infectious agent is the cause, and obtaining reliable figures, is difficult.
What we do know is that the proportion of cancers related to infections is higher in countries such as the Philippines ( nearly a quarter ) compared to the UK ( one in twenty ). A number of infectious agents have been associated with cancers – some of them rare. The four main culprits:-
• Hepatitis B and C ( HBV and HBC ) viruses and liver cancer. Most – but not all – are caused by HBV. Infection with HBV, and liver cancer, is much commoner in the Philippines compared to UK . HBV vaccine is available - for those at high risk - in the UK. Increased vaccine coverage should be a greater priority in the Philippines to reduce the numbers of this sinister and often untreatable cancer. No HBC vaccine is yet available.
• Human Papilloma Viruses ( HPV ). Cervical cancer is caused by certain strains of HPV ( most are harmless ). This is another cancer which is much commoner in the Philippines. Screening is effective ( “ smear tests “, and others ) for early abnormalities which might – untreated – lead to cancer. A vaccine is also available, which should be given to girls aged 12-13. This is part of a well developed immunisation programme in the UK. Screening and vaccination are gaining acceptance among Filipinas.
• Helicobacter pylori. This causes stomach inflammation ( gastritis ) and ulcers. There is no vaccine but a course of antibiotics is effective. Certain helicobacter strains are one risk factor for stomach cancer – another with a bad outlook, but fortunately rare in the UK and relatively uncommon in the Philippines.

There is still a low cancer prevention awareness, most cancer patients seek consultation only at advanced stages, and cancer survival rates are relatively low in the Philippines. The UK fares better, but not as well as several comparable countries.
Different types of cancer vary in frequency and how well they’re treated throughout the world. Preventing / treating infections known to be associated with cancers would help slow down the worldwide increase in cancer rates.

[stevewool]

cancer, we are all efected by this, someone we know will die of some form of cancer, i just hope i have had my share allready

[grahamw48]

Gulp.

If I make it to 80 it will be against all odds. :cwm3:

[imagine]

thanks for the info Doc Allan ,



graham , i just cant imagine me getting to 80, lol, but then 20 yrs ago i didnt imagine getting to 58 :Erm::icon_lol:

[mickcant]

Thanks Doc,
My eldest brother was found to have Oesophageal Cancer on in Nov 2010.

He had a big operation that took away part of his stomach, he was given the all clear but after problems he has it back, they do not know yet what can be done, except they cannot operate again, so that only leaves radiotherapy and chemo, he is waiting to see the specialist.
Mick.

[Doc Alan]

Thanks for appreciating my update Mick, also other members who have read and responded to it ( Steve, Graham and Imagine ).
Naturally I’m sorry to learn about your brother, and I’m sure you’re aware the outlook is not usually good . Unfortunately the oesophagus ( gullet ) is a site where cancer is increasingly diagnosed in the UK, especially in men. It’s the ninth most common cancer in UK - relatively less common in Philippines. Risk factors may include smoking, obesity, alcohol consumption and acid reflux – but most people having these DON’T get this type of cancer, and we don’t yet fully understand why it may develop in others. Ironically helicobacter may decrease the risk of one type of this cancer ( while causing illness elsewhere, as I have already said ).

[mickcant]

Hi Doc,
Thanks again, I thought there was a tie up with alcohol, he has been a moderate whiskey drinker most of his adult life but I have never seem him the worst for wear.

He also used to smoke cigars but stopped that around 20 years ago.

We can only wait and see what happpens when the specalist advice him.
Mick.

[Doc Alan]

How sad that such an important topic has been so far read by only one in six of the active membership , with a handful of replies. The forum is not primarily medical, but it is for information, not just for older members.
The topic concerns ALL members !
• Cervical cancer is preventable ! But it kills 1000 British women each year, and four times that number in Philippines. Having sex and HPV are the main risk factors.
• Screening – commonly the smear test – from the early 20’s detects changes, which can easily be treated, preventing cancer. Yet a fifth of women in UK, and far more in Philippines, don’t have this test. There’s no excuse in the UK where it’s free – and several reasons why uptake of screening remains low in Philippines.
• The HPV vaccine course is also free in the UK and should be started age 12-13. There’s an argument for vaccinating boys to prevent other – less common – cancers, but so far that is not free, and it may well have to be paid for in Philippines.
• Chronic hepatitis B infection is FAR commoner in Philippines ( 1/10 ) than UK ( 1/350 ) – but, again, HBV vaccine is available in both our countries for at risk individuals ( the list is too long for this post – see http://www.patient.co.uk/health/Hepatitis-B-Immunisation.htm for example ). Just like hepatitis C, the virus causes liver inflammation, then cirrhosis, then cancer in a proportion of individuals. This takes years to develop, but still no reason for young people to ignore it.
• Half the world’s population is walking round with helicobacter, the “ bug “ associated with most stomach cancers, one of the world’s commonest types – again affecting an older age group. Screening for this bug is part of investigation for stomach pains and chronic indigestion.
• If you do nothing else, THINK about cervical screening and the two vaccines which can prevent so many cancers !
There are many important topics, with experts, on this forum which rightly attract views – sometimes thousands – and responses. Ignore health issues if you wish – there are many other ways I can use my free time.

[Doc Alan]

How sad that such an important topic has - so far - been read by so few of the active membership , with a handful of replies. The forum is not primarily medical, but it IS for information.
The topic concerns ALL members directly or indirectly !
• Cervical cancer is preventable ! But it kills 1000 British women each year, and four times that number in Philippines. Having sex and HPV are the main risk factors.
• Screening – commonly the smear test – from the early 20’s detects changes, which can easily be treated, preventing cancer. Yet a fifth of women in UK, and far more in Philippines, don’t have this test. There’s no excuse in the UK where it’s free – and several reasons why uptake of screening remains low in Philippines.
• The HPV vaccine course is also free in the UK and should be started age 12-13. There’s an argument for vaccinating boys to prevent other – less common – cancers, but so far that is not free, and it may well have to be paid for in Philippines.
• Chronic hepatitis B infection is FAR commoner in Philippines ( 1/10 ) than UK ( 1/350 ) – but, again, HBV vaccine is available in both our countries for at risk individuals ( the list is too long for this post – see http://www.patient.co.uk/health/Hepatitis-B-Immunisation.htm for example ). Just like hepatitis C, the virus causes liver inflammation, then cirrhosis, then cancer in a proportion of individuals. This takes years to develop, but still no reason for young people to ignore it.
• Half the world’s population is walking round with helicobacter, the “ bug “ associated with most stomach cancers, one of the world’s commonest types – again affecting an older age group. Screening for this bug is part of investigation for stomach pains and chronic indigestion.
• If you do nothing else, consider, have, or recommend cervical screening and the two vaccines which can prevent so many cancers - the point of this thread !