Book: Infections and Human Cancer: Cancer Surveys, Volume 33
Authors: Dimitrios Trichopoulos
Journal: BMJ (1999)

Eds Robert Newton, Valerie Beral, Robin A Weiss

Cold Spring Harbor Laboratory Press, $93, pp 396

ISBN 0 87969 549 8

Microbes and Malignancy: Infection as a cause of human cancers

Ed Julie Parsonnet

Oxford University Press, £59.50, pp 478

ISBN 0 19 510401 3 

———————

Rating: ★★★, ★★★

  Few readers have avoided the unpleasant surprise of getting or, worse, buying a book with an attractive title, distinguished editors, and outstanding authors, only to find that what they have got is a collection of essays, reviews, or even research papers that were written on the occasion of a scientific meeting or without a clearly stated objective or a guiding principle. There is no such risk with these two books, each of which presents authoritative and critical overviews of the evidence concerning the infectious aetiology of several common and some uncommon forms of human cancer.

The books will fill a gap that formed over the past 30 years with the establishment of infections as causes of such common malignancies as cancers of the cervix, the liver, and the stomach. Indeed, it seems now that human papillomaviruses, hepatitis viruses, and perhaps Helicobacter pylori are far more important causes of human cancer than any of the physical or chemical agents most people in Western societies are currently concerned about—with the obvious exception of tobacco smoking.


Both books are comprehensive in covering viruses, parasites, and bacteria, and both examine the empirical evidence, as well as mechanistic phenomena, that are considered to be crucial in the respective carcinogenic processes. Microbes and Malignancy has a useful section on mechanisms of infection induced malignancy, whereas screening and vaccination against infectious agents are considered in special chapters in Infections and Human Cancer. 






The books are more tuned to the needs of the experienced specialist than to those of the aspiring beginner. If they have a weakness it is that the epidemiological evidence, which has driven the International Agency for Research on Cancer to conclude that most of the infectious agents considered are established human carcinogens, does not receive as much attention as the biological processes and molecular mechanisms—notwithstanding the presence of distinguished epidemiologists among the authors and editors of the books.

Both books deserve our admiration, however, for the lucid and coherent way that they present complex topics, the investigation of which has required the simultaneous consideration of principles of infectious diseases, epidemiology of chronic diseases, and molecular biology. The books are also useful because they help to formalise an important development that has taken place with unusual speed—that is, the realisation that infectious agents are important causes of human pathology above and beyond the realm of traditional communicable diseases. The discovery of infectious and eventually controllable causes of disease is always good news, particularly in an era that is threatened by genetic determinism.