Background Infectious pathogens are strong and modifiable causes of cancer. The aim of this study was to improve estimates of the global and regional burden of infection-attributable cancers to inform research priorities and facilitate prevention efforts. Methods We used the GLOBOCAN 2018 database of cancer incidence and mortality rates and estimated the attributable fractions and global incidence for specific anatomical cancer sites, subsites, or histological subtypes known to be associated with ten infectious pathogens classified as human carcinogens. We calculated absolute numbers and age-standardised incidence rates (ASIR) of infection-attributable cancers at the country level. Estimates were stratified for sex, age group, and country, and were aggregated according to geographical regions and World Bank income groups. Findings We found that, for 2018, an estimated 2•2 million infection-attributable cancer cases were diagnosed worldwide, corresponding to an infection-attributable ASIR of 25•0 cases per 100 000 person-years. Primary causes were Helicobacter pylori (810 000 cases, ASIR 8•7 cases per 100 000 person-years), human papillomavirus (690 000, 8•0), hepatitis B virus (360 000, 4•1) and hepatitis C virus (160 000, 1•7). Infection-attributable ASIR was highest in eastern Asia (37•9 cases per 100 000 person-years) and sub-Saharan Africa (33•1), and lowest in northern Europe (13•6) and western Asia (13•8). China accounted for a third of worldwide cancer cases attributable to infection, driven by high ASIR of H pylori (15•6) and hepatitis B virus (11•7) infection. The cancer burden attributed to human papillomavirus showed the clearest relationship with country income level (from ASIR of 6•9 cases per 100 000 personyears in high-income countries to 16•1 in low-income countries). Interpretation Infection-attributable cancer incidence, in addition to the absolute number of cases, allows for refined geographic analyses and identification of populations with a high infection-associated cancer burden. When cancer prevention is largely considered in a non-communicable disease context, there is a crucial need for resources directed towards cancer prevention programmes that target infection, particularly in high-risk populations. Such interventions can markedly reduce the increasing cancer burden and associated mortality.

Globally accelerating trends in societal development and human environmental impacts since the mid-twentieth century are known as the Great Acceleration and have been discussed as a key indicator of the onset of the Anthropocene epoch . While reports on ecological responses (for example, changes in species range or local extinctions) to the Great Acceleration are multiplying , it is unknown whether such biotic responses are undergoing a similar acceleration over time. This knowledge gap stems from the limited availability of time series data on biodiversity changes across large temporal and geographical extents. Here we use a dataset of repeated plant surveys from 302 mountain summits across Europe, spanning 145 years of observation, to assess the temporal trajectory of mountain biodiversity changes as a globally coherent imprint of the Anthropocene. We find a continent-wide acceleration in the rate of increase in plant species richness, with five times as much species enrichment between 2007 and 2016 as fifty years ago, between 1957 and 1966. This acceleration is strikingly synchronized with accelerated global warming and is not linked to alternative global change drivers. The accelerating increases in species richness on mountain summits across this broad spatial extent demonstrate that acceleration in climate-induced biotic change is occurring even in remote places on Earth, with potentially far-ranging consequences not only for biodiversity, but also for ecosystem functioning and services.

Plant functional trait change across a warming tundra biomeThe tundra is warming more rapidly than any other biome on Earth, and the potential ramifications are far-reaching because of global feedback effects between vegetation and climate. A better understanding of how environmental factors shape plant structure and function is crucial for predicting the consequences of environmental change for ecosystem functioning. Here we explore the biome-wide relationships between temperature, moisture and seven key plant functional traits both across space and over three decades of warming at 117 tundra locations. Spatial temperature-trait relationships were generally strong but soil moisture had a marked influence on the strength and direction of these relationships, highlighting the potentially important influence of changes in water availability on future trait shifts in tundra plant communities. Community height increased with warming across all sites over the past three decades, but other traits lagged far behind predicted rates of change. Our findings highlight the challenge of using space-for-time substitution to predict the functional consequences of future warming and suggest that functions that are tied closely to plant height will experience the most rapid change. They also reveal the strength with which environmental factors shape biotic communities at the coldest extremes of the planet and will help to improve projections of functional changes in tundra ecosystems with climate warming. Environment-trait relationships across the tundra biomeWe found strong spatial associations between temperature and community height, SLA and LDMC (Fig. 2a, Extended Data Fig. 2 and Supplementary Table 3) across the 117 survey sites. Both height and SLA increased with summer temperature, but the temperaturetrait relationship for SLA was much stronger at wetter than at drier sites. LDMC was negatively related to temperature, and