IARC's 2024 count makes Epstein-Barr the largest cancer-causing virus without a vaccine
IARC attributes 2.3 million of 2024's new cancers to infections, about 260,000 of them to Epstein-Barr, a virus no vaccine yet prevents. Infections that current vaccines and antibiotics can already stop still cause far more of the total.
The Scientist · Science desk
What happened
- H. pylori was linked to about 760,000 cases, almost all of them stomach cancers and more than half in eastern Asia.
- The study treats HPV as the cause of every cervical cancer, about 600,000 of the roughly 750,000 cases it links to that virus.
- About 80 percent of Southeast Asia's 34,000 Epstein-Barr cancers were nasopharyngeal, while Europe and the Americas saw more stomach cancer and lymphoma.
- In sub-Saharan Africa, Burkitt lymphoma made up a notable share of Epstein-Barr cancers, and the authors flag malaria as a possible contributor.
Why it matters
- Who has to decide decision Money earmarked for new prevention tools has its clearest cancer target in Epstein-Barr vaccines, since every larger infection-linked burden already has a vaccine or a drug.
- What it limits constraint Anyone comparing the 2024 figures with 2018's has to strip out newly counted Epstein-Barr cancers before claiming the virus's burden grew.
- What's now possible capability One HPV dose protecting as well as two or three means a fixed vaccine supply can reach more girls in sub-Saharan Africa.
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About 38 percent of the Epstein-Barr total comes from cancers that earlier global estimates did not count against the virus [27]. Stomach cancer and two more types of lymphoma joined its list only recently, and together they make up about 100,000 of its 260,000 cases [13]. The last estimate of this kind dates from 2018 [14]. Since then, Clifford told Scientific American, research has linked the virus to some stomach cancers and some rarer lymphomas [14].
"This updated analysis shows that the landscape of infection-related cancers continues to evolve as scientific evidence advances," said Gary Clifford, an epidemiologist at the International Agency for Research on Cancer and the study's senior co-author, in a press release [15]. "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." [15]
The ranking supports him. Epstein-Barr's total is topped only by H. pylori, HPV and hepatitis B [2], and each of those has a tool. Antibiotics can clear H. pylori [4]. Vaccines prevent HPV and hepatitis B, and antivirals treat hepatitis B and C [8][17]. Epstein-Barr has no vaccine and no reliable way to control it once someone is infected, though several vaccines are in testing [16]. That makes it the largest cancer burden in the study with no tool against the infection itself [25].
Clifford's wider point to Scientific American was about tools that already exist. "These are very actionable risk factors. We can test for them. We can vaccinate against them," he said [19]. By case count, most of the preventable burden sits there. H. pylori and HPV together account for about 1.51 million cases [21], nearly six times the Epstein-Barr figure [22]. Add hepatitis B's roughly 360,000 [7] and the four named infections reach about 2.13 million, leaving roughly 170,000, on rounded figures, for everything else [24]. Five of the 12 infections studied caused nearly all of the total [6].
Delivery is uneven. In sub-Saharan Africa the rate of HPV-caused cancer is more than twice the global average [9]. Clifford attributed the region's higher rates partly to "disparities in investment," such as a lack of cervical cancer screening programs [10].
The strongest evidence that a vaccine changes these numbers comes from HPV, whose vaccine was first introduced in the US in 2006. In some states, cervical cancer rates have dropped by more than 50 percent among women aged 20 to 31, the first group eligible for the vaccine as preteens [17]. The comparison is observational, across cohorts, and not a trial. "There is no question that this vaccine does what it was intended to do," said Anna Giuliano, founding director of the Center for Immunization and Infection Research in Cancer at Moffitt Cancer Center [18].
Epstein-Barr is a harder target. The virus lives in nearly every adult and stays for life [11], yet only a small share of carriers ever develop a related cancer [12]. Genes, diet, surroundings, other infections and weakened immunity are all candidate cofactors [12]. The thing the 260,000 figure doesn't tell you is how many of those cancers a vaccine would prevent. The candidates are still in testing [16], and neither report includes trial results.
I think the evidence supports Clifford's case that Epstein-Barr is where money for new prevention tools would do the most, provided the newly counted stomach cancers and lymphomas hold up under further study [13][15].
What to watch
- Efficacy results from the Epstein-Barr vaccines now in testing, the first data on how much of the virus's cancer burden vaccination can prevent.
- Further studies of the Epstein-Barr link to stomach cancer and the two newly counted lymphomas, on which the virus's ranking now depends.
- Whether single-dose HPV programs in sub-Saharan Africa bring the region's HPV-caused cancer rate closer to the global average.
Clarity's read
What the record supports and how the coverage leans. The claims behind it follow.
Reality
- Evidence72
- Adoption30
- Hype gap+8
- Incentives
- Not scored
- Confidence70
Perspective Coverage
4 publishers- Builder
- Builder 25%
- Operator
- Operator 59%
- Investor
- Investor 16%
Claim ledger
Ranked by verification strength, evidence, and original report placement.
- [1]
Researchers at the International Agency for Research on Cancer (IARC), in a study published in The Lancet Oncology, attribute 2.3 million new cancer cases in 2024, more than a tenth of the world's total, to infections.
- [2]
Epstein-Barr virus was linked to about 260,000 of the infection-attributed cancer cases, a total topped only by H. pylori, HPV and hepatitis B.
- [3]
Infections were responsible for approximately 2.3 million cancer cases, about 12 percent of diagnoses (one in eight), worldwide in 2024.
- [4]
H. pylori 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.
- [5]
HPV was linked to about 750,000 cases and is treated in the study as the cause of every cervical cancer, about 600,000 in 2024.
- [6]
Five of the 12 infections studied, including Epstein-Barr, caused nearly all of the 2.3 million cases.
- [7]
An estimated 360,000 cancer cases were linked to hepatitis B infections.
- [8]
Hepatitis B can be prevented with a vaccine, and antiviral drugs treat hepatitis B and C.
- [9]
In sub-Saharan Africa the rate of HPV-caused cancer is more than twice the global average.
- [10]
Clifford says sub-Saharan Africa's higher rates of infection-caused cancers are in part because of "disparities in investment," such as a lack of cervical cancer screening programs.
- [11]
Epstein-Barr virus lives in nearly every adult on Earth and, once caught, stays in the body for life.
- [12]
Only a small share of Epstein-Barr carriers ever develop a related cancer; possible other factors include people's genes, their diets and surroundings, other infections, and weakened immunity.
- [13]
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.
- [14]
The new estimates update older research conducted in 2018; since then, Clifford says, researchers have discovered that Epstein-Barr virus is also linked to some stomach cancers and some rarer lymphomas.
- [15]
"This updated analysis shows that the landscape of infection-related cancers continues to evolve as scientific evidence advances. 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."
- [16]
Epstein-Barr has no vaccine or reliable way to control it once someone is infected, although several vaccines are being tested.
- [17]
The HPV vaccine was first introduced in the US in 2006; since then cervical cancer rates have dropped in some states by more than 50 percent among women aged 20 to 31, the first group eligible to receive the vaccine as preteens.
- [18]
"There is no question that this vaccine does what it was intended to do."
- [19]
"These are very actionable risk factors. We can test for them. We can vaccinate against them."
- [20]
A single HPV vaccine dose protects as well as two or three, which could help reach more girls in sub-Saharan Africa.
- [21]
H. pylori and HPV together account for about 1.51 million cases.
- [22]
H. pylori and HPV cases combined are nearly six times the Epstein-Barr total.
- [23]
In Southeast Asia about 80 percent of the region's 34,000 Epstein-Barr cancers were nasopharyngeal; in Europe and the Americas the virus more often leads to stomach cancer or lymphoma.
- [24]
The four named infections account for about 2.13 million of the 2.3 million cases, leaving roughly 170,000 on rounded figures for the other infections.
- [25]
Epstein-Barr is the largest infection-linked cancer burden in the study with no vaccine or treatment against the infection itself.
- [26]
In sub-Saharan Africa nasopharyngeal cancer also led among Epstein-Barr cancers, but Burkitt lymphoma made up a notable share, and the authors flag malaria as a possible contributor.
- [27]
About 38 percent of Epstein-Barr's attributed cancer cases come from newly counted cancer types.
Sources
4 independent publishers whose own reporting we read for this story.
- discovermagazine.com5 Infections, Including Epstein-Barr Virus, Were Linked to 2.3 Million New Cancer Cases in 2024
1 article · September 29, 2026
- livescience.com1 in 8 cancer cases are caused by infections, underscoring the importance of vaccines, experts say
1 article · October 3, 2026
- mezha.netІнфекції пов’язали з 2,3 млн випадків раку у світі за 2024 рік
2 articles · October 5, 2026
- scientificamerican.comOne in eight new cancers are likely caused by infections—there’s an easy way to protect yourself
1 article · September 28, 2026
Topics and entities
Topics
- Global cancer burden
- Infection-related cancer
- Vaccines against cancer-causing infections
Entities
- Helicobacter pylori
- Hepatitis B virus
- International Agency for Research on Cancer
- Claire Shannon-Lowe
- World Health Organization
- Epstein-Barr virus
- The Lancet Oncology
- Human Papillomavirus (HPV)