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The International Journal of the Royal Society of Thailand
Volume XI - 2019

1. Cancer

Cancer is multifactorial complex diseases; genetic, carcinogen and
infectious agents such as Hepatitis B virus (HBV), Hepatitis C virus (HCV),
Human Papillomavirus (HPV) are the known etiology for cancers. Having
exposed to carcinogens or the oncovirus in addition to the host genetic

predisposing to cancer, are the likely causes of cancer for various cancers.
The host factors influencing cancer development are likely the results of the
host and pathogens genetic variations.
There are seven known virus causing cancers, including Epstein-Barr
Virus (EBV) associated with nasopharyngeal carcinoma and gastric cancer,
In Thailand, the parasitic infection along the biliary tract by Opistorchis Viverini
is the most common cause of cholangiocarcinoma. Detection of infection state of

these oncovirus and parasitic infection are the vital strategy in preventing these
cancers in Thailand. The development of the vaccine to prevent high risk HPV
infection results in almost elimination of cervical cancers from the HPV in the
vaccine targeted HPV serotype. Vaccine research would be vital in reducing
these infections associated cancers at the population levels.

Around 8–12 % of cancer cancer patients in the population is cause solely
by the rare mutations that predisposing at risk carrier to cancers (Huang et al.,
2018). These mutations are characterized by high penetrance, such as BRCA1/
BRCA2 mutations carrier having 80% lifetime risk of developing breast cancer.
From many types of these familial cancer syndrome, two diseases are more
common and genetic tests offered in developed economy, such as Familial
Breast and Ovarian Cancer, Lynch’s Syndrome or Hereditary Non-polyposis
Colon Cancer. Many of these diseases are very rare, diseases such as Le
Fraumeni’s Syndrome is uncommon but vital for early detection of cancer,
because cancer can be developed in early childhood, the earlier onset of cancer
in these families results in the delay detection of cancer at early stage and
eventually poor prognostic from cancers in these rare familial cancer.

Family with familial cancer syndromes are usually presented by multiple
family members developed cancers. Family member with at risk mutations, usually
develop multiple types of cancer. Mutation testing is diagnostic for these
families, changing the paradigm of cancer prevention, because multiple
screening methods could be applied for those with at risk mutations, even

Surakameth Mahasirimongkol
Sacarin Bunbanjerdsuk 91

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