Cervical Cancer: Open Access
Open Access

HPV; Cervical cancer; Sexually transmitted infection; Prevention; Vaccination; Screening; Public health

Introduction

Cervical cancer is a leading cause of cancer-related deaths among women globally, particularly in low- and middle-income countries where access to healthcare is limited. Approximately 99% of cervical cancer cases are linked to persistent infection with high-risk human papillomavirus (HR-HPV) types. Among the more than 200 types of HPV identified, HPV-16 and HPV-18 are most frequently implicated in cervical cancer development [1-3]. Despite the widespread prevalence of HPV, cervical cancer is largely preventable through vaccination and routine screening.

Understanding the link between HPV and cervical cancer is essential for public health initiatives aimed at reducing the incidence and mortality of this disease. This article delves into the molecular pathways of HPV-induced carcinogenesis, identifies epidemiological risk factors, and discusses existing and emerging prevention strategies [4-6].

Description

HPV is a non-enveloped, double-stranded DNA virus belonging to the Papillomaviridae family. It infects epithelial cells and is transmitted through direct skin-to-skin contact, most commonly during sexual activity. HPV is categorized into low-risk types (e.g., HPV-6 and HPV-11, associated with genital warts) and high-risk types (e.g., HPV-16 and HPV-18, associated with cancer).

Initial Infection HPV infects basal epithelial cells of the cervix following micro-abrasions. The virus integrates into the host cell genome and disrupts normal cellular functions. E6 and E7 Oncoproteins High-risk HPV types express E6 and E7 oncoproteins, which inactivate tumor suppressor proteins p53 and retinoblastoma (Rb), respectively. This disruption allows for unregulated cell proliferation, genomic instability, and evasion of apoptosis. Progression to Malignancy Persistent infection with HR-HPV types leads to the development of precancerous lesions (cervical intraepithelial neoplasia or CIN) and, eventually, invasive cervical cancer if untreated. HPV infection is nearly universal among sexually active individuals. However, most infections are transient and cleared by the immune system within two years. Persistent HR-HPV infection is the primary risk factor for cervical cancer. Other contributing factors include [7-9].

Early Sexual Activity and Multiple Partners Increased exposure heightens the risk of acquiring HR-HPV. Immunosuppression Conditions such as HIV/AIDS reduce the body’s ability to clear HPV. Tobacco Use Smoking contributes to the persistence of HPV and progression to malignancy. Socioeconomic Status Limited access to screening and vaccination exacerbates risk [10].

Discussion

Prevention efforts focus on reducing the incidence of HPV infection and early detection of cervical precancerous lesions. Vaccination HPV vaccines, such as the quadrivalent and nonavalent vaccines, protect against HR-HPV types. Introduced globally, these vaccines have demonstrated substantial reductions in HPV infections, genital warts, and precancerous lesions. Vaccination is most effective when administered before the onset of sexual activity, with many countries implementing school-based programs for preadolescents. Screening Routine cervical cancer screening via Pap tests and HPV testing enables early detection of abnormal cervical changes. Advances in liquid-based cytology and HPV DNA testing have enhanced the sensitivity and specificity of screening methods.

Public Education Educating individuals about HPV transmission and cervical cancer prevention is essential. Community outreach programs and awareness campaigns can address cultural stigma and misinformation. Despite the availability of vaccines and screening, barriers persist: Access to Healthcare Many low-income settings lack the infrastructure to support widespread vaccination and screening programs. Vaccine Hesitancy Misinformation about vaccine safety has led to suboptimal uptake in some regions. Cultural and Social Factors Stigma and lack of awareness hinder participation in preventive measures.

Research efforts are underway to develop therapeutic vaccines aimed at treating existing HPV infections. Additionally, innovations in self-sampling for HPV testing promise to increase screening coverage, particularly in underserved areas. Global initiatives, such as the WHO’s goal to eliminate cervical cancer as a public health problem, highlight the importance of collaborative efforts in reducing the burden of disease.

Conclusion

The link between HPV and cervical cancer is well-established, offering opportunities for effective prevention through vaccination and screening. While significant progress has been made in reducing cervical cancer incidence in high-resource settings, disparities remain. Addressing these gaps requires a multifaceted approach, encompassing increased access to healthcare, education, and public health infrastructure. By leveraging advancements in technology and fostering global cooperation, it is possible to move closer to the elimination of cervical cancer as a global health threat.

Acknowledgement

None

Conflict of Interest

None

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