Closing the Mechanism Loop: A Unified Mechanistic Framework for Parasite-Associated Carcinogenesis

Background. Six parasite–cancer associations are supported by IARC carcinogen classification or strong mechanistic and epidemiological evidence: Schistosoma haematobium → bladder cancer (Group 1); Opisthorchis viverrini and Clonorchis sinensis → cholangiocarcinoma (Group 1); Schistosoma japonicum → colorectal cancer (Group 2B, priority reclassification); Plasmodium falciparum → endemic Burkitt lymphoma (Group 2A, reclassification evidence reviewed in Study 8 ([10.5281/zenodo.20402639](https://doi.org/10.5281/zenodo.20402639))); and Strongyloides stercoralis × HTLV-1 → adult T-cell leukemia/lymphoma (mechanistic evidence reviewed in Study 9 ([10.5281/zenodo.20402641](https://doi.org/10.5281/zenodo.20402641))). These associations span five parasite taxa, four cancer types, and four continents. No synthesis has mapped their underlying mechanisms onto a common framework. Methods. Narrative mechanistic synthesis. PubMed and Google Scholar were searched for publications on: (1) parasite-induced inflammation and genotoxicity; (2) helminth-driven immune polarisation; (3) parasite extracellular vesicles and epigenetic reprogramming; (4) parasite–oncovirus amplification systems. Results are...