Shifting the center of gravity for addressing the rising cancer disease burden in Africa: A rationale for African-based integrative infectious diseases and oncology research

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Regardless of location, few people have escaped being touched by cancer and infectious diseases.Since the COVID-19 pandemic began, the world has a new-found respect for infectious diseases threats; people everywhere on the planet already had an awareness and substantial fear of cancer.The relationships between infectious diseases and cancer are clear, although we have a lot to learn.Potential vaccine-mediated prevention of >90% of cervical cancers arising from the recognition of human papillomavirus (HPV) oncogenicity [1], as well as the impact of prevention and management of hepatitis B and C viral infection on dramatically reducing hepatocellular carcinoma burden [2, 3], are the most striking examples of the value of exploring such linkages.Helicobacter pylori and gastric cancer [4], Schistosoma haematobium and bladder cancer [5], Epstein-Barr virus and Burkitt's lymphoma [6], and Human Herpesvirus 8 (HHV8) and Kaposi's Sarcoma [7] are other notable examples.Simplistically, infections trigger cancers through chronic inflammation of the tissues they infect, creating the potential for oncogenic mutations in those tissues, but there are multiple processes that contribute at cellular, interstitial, immunologic, vascular and molecular levels, as well as co-factors with innate host characteristics, environmental exposures, especially radiation and toxins, and potentially additional pathogens or pathogen-related substances.Infections and oncogenesis have been characterized with a sufficient number of cancers to wonder whether we are, thus far, just scratching the surface.Upon receiving the Nobel Prize for his work on HPV and cervical cancer in 2005, Harald zur Hausen predicted more discoveries in this field-he was correct-and research efforts on infectious diseases and cancer did expand.At least 800,000 new cancers were estimated for Africa in 2020 with >500,000 deaths, likely underestimated because of limitations in diagnostics and reporting; by 2040, 1.5 million new cases and one million deaths are projected [8].Cancer prevention, detection, and management

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