Epstein-Barr virus lives in nearly every adult on Earth, usually without causing any trouble. When it does lead to cancer, which cancer seems to depend on where you live. In Southeast Asia, it’s mostly tumors in the part of the throat behind the nose. In Europe and the Americas, it’s more often stomach cancer or lymphoma.
That pattern shows up in a new global estimate of cancers caused by infections, published in The Lancet Oncology by researchers at the International Agency for Research on Cancer (IARC). The study attributes 2.3 million new cancer cases in 2024, more than a tenth of the world’s total, to infections. Epstein-Barr, the virus behind mononucleosis (mono), was linked to about 260,000 of them, a total topped only by H. pylori, HPV, and hepatitis B.
“This updated analysis shows that the landscape of infection-related cancers continues to evolve as scientific evidence advances,” said Gary Clifford, senior co-author of the study, in a press release. “It also highlights where future investments in new prevention tools could have the greatest impact, particularly for infections such as EBV, for which effective vaccines are not yet available.”
Why One Virus Leads to Different Cancers
Once someone catches Epstein-Barr, the virus stays in their body for life, hidden inside some of their cells. Proteins the virus makes can push those cells to keep dividing, one step on the path to cancer.
Explore All OptionsYet only a small share of the carriers ever develop a related cancer. That gap, along with the way the cancers vary from region to region, hints that other factors are involved. Among the possibilities are people's genes, their diets and surroundings, other infections, and weakened immunity.
The split is the strongest in Southeast Asia, where about 80 percent of the region’s 34,000 Epstein-Barr cancers were nasopharyngeal (the tumors that form in the upper throat behind the nose).
Nasopharyngeal cancer also led in Sub-Saharan Africa. There, though, Burkitt lymphoma, a fast-growing cancer that often affects children, made up a notable share, and the authors flag malaria, widespread in the region, as a possible contributor.
Stomach cancer only recently joined the list of cancers counted for Epstein-Barr in these global estimates, along with two more types of lymphoma. Those newly counted cancers make up about 100,000 of the virus’s 260,000 cases.
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The Cancers We Already Know How to Prevent
Just five of the 12 infections, including Epstein-Barr, caused nearly all of the 2.3 million cases.
H. pylori, a common stomach bacterium, was linked to about 760,000 cases, almost all of them stomach cancers and more than half in eastern Asia. It can be cleared with antibiotics, and stomach cancer rates have fallen in many places as sanitation has improved and fewer infections are passed between family members.
HPV, linked to about 750,000 cases, is treated in the study as the cause of every cervical cancer, about 600,000 in 2024. It also causes throat, anal, and penile cancers. A single vaccine dose protects as well as two or three, which could help reach more girls in sub-Saharan Africa, where the rate of HPV-caused cancer is more than twice the global average.
Hepatitis B can be prevented with a vaccine too, and antiviral drugs treat hepatitis B and C. But these tools reach some places much better than others, and low- and middle-income countries accounted for 77 percent of the cases.
No Vaccines for Epstein-Barr
Epstein-Barr has no vaccine or reliable way to control it once someone is infected, although several vaccines are being tested.
Most people reading this probably picked up Epstein-Barr long ago, maybe from a parent’s kiss, or a shared spoon, and will never give it a second thought. A vaccine could one day let some of those who would otherwise get cancer from it do the same.
This article is not offering medical advice and should be used for informational purposes only.
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Article Sources
Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:
- This article references information from a study published in The Lancet Oncology: Global burden of cancer attributable to infections in 2024: a worldwide incidence analysis
- This article references information from the World Health Organization: Global burden of cancer attributable to infections in 2024: One in eight cancers worldwide linked to infections
