The role of helminth infections in carcinogenesis.

This review examines the significant literature on the role of helminth infections in carcinogenesis. Both parasitic infections and cancer have complex natural histories and long latent periods during which numerous exogenous and endogenous factors interact to obfuscate causality. Although only two helminths, Schistosoma haematobium and Opisthorchis viverrini, have been proven to be definitely carcinogenic to humans, others have been implicated in facilitating malignant transformation. The known mechanisms of helminth-induced cancer include chronic inflammation, modulation of the host immune system, inhibition of intracellular communication, disruption of proliferation-antiproliferation pathways, induction of genomic instability and stimulation of malignant stem cell progeny. Approximately 16% of all cancer cases worldwide are attributable to pathogenic agents, including schistosomes and liver flukes. This equates to 1,375,000 preventable cancer deaths per year. Means to reduce the incidence of helminth-associated malignancies are discussed.