Abstract SY08-01: Cancer in immunosuppressed populations: Epidemiologic clues to causation

Abstract

Abstract Epidemiologic studies of immunosuppressed populations (HIV-infected people and solid organ transplant recipients) can identify candidate malignancies where infection, immunity, and inflammation are likely to be etiologically important. Such studies have revealed markedly elevated risk for cancers linked to oncogenic viral infections, e.g., Kaposi sarcoma (caused by human herpesvirus 8), some non-Hodgkin lymphoma subtypes and Hodgkin lymphoma (Epstein Barr virus), anogenital cancers (human papillomavirus), and liver cancer (hepatitis B and C viruses). For these cancers, the heightened risk arises from a high prevalence of viral infection and/or loss of immune control of the infection. In contrast, risk is not elevated in immunosuppressed populations for common malignancies not strongly linked to infection (e.g., colon, prostate, and breast cancers), arguing against a more general role for immune surveillance in protecting healthy people from cancer. For a few remaining cancers, an elevated risk is observed among both HIV-infected people and transplant recipients, but the increase is not as great as for malignancies known to be caused by viruses, or data are less clearcut. Examples include various skin cancers, lung cancer, and multiple myeloma. These increased risks suggest that specific infections (with either a known or unknown agent) or altered immunity are relevant for development of these malignancies. Another possibility is that repeated or chronic infections with diverse microbes, or chronic inflammation, play a role. Citation Format: Eric A. Engels. Cancer in immunosuppressed populations: Epidemiologic clues to causation [abstract]. In: Proceedings of the AACR 101st Annual Meeting 2010; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr SY08-01