REVIEW article
Front. Cell. Infect. Microbiol.
Sec. Virus and Host
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1625818
This article is part of the Research TopicExamining Microbial Oncogenicity: Research on the Intersect of Infectious Diseases and Cancers to Reduce Disease BurdenView all 3 articles
A Landscape Review with Novel Criteria to Evaluate Microbial Drivers for Cancer: Priorities for Innovative Research Targeting Excessive Cancer Mortality in sub-Saharan Africa
Provisionally accepted
Rebecca Toumi van Dorsten1,2,3,4*
Robert F Breiman2,5*- 1Centre for HIV & Sexually Transmitted Infections, National Institute of Communicable Diseases, Johannesburg, South Africa
- 2Witwatersrand University, Infectious Disease and Oncology Research Institute, Johannnesburg, South Africa
- 3SAMRC Antiviral Gene Therapy Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- 4Rubic One Health, Johannesburg, South Africa
- 5Rollins School of Public Health, Emory University, Atlanta, United States
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This review confronts the escalating cancer burden in Sub-Saharan Africa (SSA), arguing that microbial infections represent a significant, yet incompletely understood, etiological factor. While acknowledging the established roles of pathogens such as human papillomavirus (HPV) and hepatitis B and C viruses (HBV, HCV) and Helicobacter pylori in specific cancers, we contend that a broader spectrum of microbial agents may contribute to oncogenesis in the region. This work synthesizes current knowledge of direct and indirect mechanisms by which microbes can influence cancer development, encompassing viral oncogenes, chronic inflammation, and immunosuppression, with particular attention to the impact of HIV co-infection. Furthermore, we critically evaluate existing frameworks for establishing causation and propose a modified set of criteria tailored to the complexities of microbial oncogenesis.By highlighting specific microbial candidates and advocating for the integration of advanced research methodologies, including multi-omics approaches and machine learning, this review underscores the urgent need for further investigation into the role of microbial infections in driving cancer disparities in SSA, with the goal of informing targeted prevention and therapeutic strategies.
Keywords: Infectious Disease, criteria for microbial oncogenesis, Cancer causation, Sub Saharan Africa (SSA), Oncovirus and cancer, infectious disease and cancer, microbiome and cancer
Received: 09 May 2025; Accepted: 21 Jul 2025.
Copyright: © 2025 van Dorsten and Breiman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Rebecca Toumi van Dorsten, Centre for HIV & Sexually Transmitted Infections, National Institute of Communicable Diseases, Johannesburg, South Africa
Robert F Breiman, Witwatersrand University, Infectious Disease and Oncology Research Institute, Johannnesburg, South Africa
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.