Implementing legislation that restricts the use of tanning beds among youth is important to prevent use of these devices, especially because youth who use tanning beds by 17 years of age are twice as likely to continue using these devices as adults (208). Currently, 44 states and the District of Columbia either ban or regulate the use of indoor tanning devices by minors (209). All states should enact legislation banning indoor tanning for minors, to continue the downward trend of tanning bed usage, especially among youth. Prevent and Eliminate Infection from Cancercausing Pathogens Cancer-causing pathogens (bacteria, viruses, and parasites) increase a person’s risk for several types of cancer (see Table 2, p. 48). Infection with these agents can change the way a cell behaves, weaken the immune system, and cause chronic inflammation, all of which can lead to cancer. In the United States, about three percent of all cancer cases are attributable to infection with pathogens (147). Globally, an estimated 13 percent (2.2 million) of all cancer cases in 2018 were attributable to pathogenic infections, with more than 90 percent of these cases attributable to four pathogens: human papillomavirus (HPV), hepatitis B (HBV), hepatitis C (HCV), and Helicobacter pylori (212). Individuals can significantly lower their risks by protecting themselves from infection or by seeking treatment, if available, to eliminate an infection (see Sidebar 15, p. 49). Human papillomavirus is a group of more than 200 related viruses that are responsible for almost all cervical cancers, 90 percent of anal cancers, and 70 percent of oropharyngeal cancers, as well as most penile, vaginal, and vulvar cancers. While most Cancer-causing Pathogens BACTERIA Pathogen Cancer types caused by the pathogen Number of global cancer cases Helicobacter pylori Stomach cancer and non-Hodgkin lymphoma 810,000 PARASITES Pathogen Cancer types caused by the pathogen Number of global cancer cases Clonorchis sinensis and Opisthorchis viverrini Cholangiocarcinoma 3,500 Schistosoma haematobium Bladder cancer Not available VIRUS Pathogen Cancer types caused by the pathogen Number of global cancer cases Epstein-Barr Virus (EBV) Hodgkin lymphoma, certain types of nonHodgkin lymphoma, and nasopharyngeal cancer 156,600 Hepatitis B Virus (HBV) Hepatocellular carcinoma and other cancers 360,000 Hepatitis C Virus (HCV) Hepatocellular carcinoma and other cancers 156,000 Human Herpes Virus type-8 (HHV-8; also known as Kaposi sarcoma herpes virus) Kaposi sarcoma 42,000 Human Immunodeficiency Virus (HIV) Kaposi sarcoma and non-Hodgkin lymphoma Not available Human Papillomavirus (HPV) Anal, cervical, head and neck, larynx, oral, oropharyngeal, penile, vaginal, and vulvar cancers 690,000 Human T-cell Lymphotrophic Virus, type 1 (HTLV-1) T-cell leukemia and lymphoma 3,600 Merkel Cell Polyomavirus (MCV) Skin cancer Not available Adapted from (1). TABLE 2 AACR Cancer Progress Report 2023 Reducing the Risk of Cancer Development 48
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