Human Papillomavirus Infection and Cervical Cancer: Epidemiology, Screening, and Vaccination-Review of Current Perspectives

The effect of the music-supported education program on the awareness and health beliefs of Roma women about cervical cancer and screening

BACKGROUND

Roma women, who have low education, are one of the risk groups for cervical cancer as it has proven that they marry and give birth at an early age and have limited access to preventive health services.

AIM

This study aims to reveal the effect of a music-supported education program based on the Health Belief Model on the awareness and health beliefs of Roma women about cervical cancer and screening.

METHODS

This study was conducted between June 2021- January 2022 with 40 Roma women in the experimental group and 40 in the control group. Data were collected using the Personal Information Form and the Health Belief Model Scale for Cervical Cancer and Pap Smear Test. The experimental group received a four-week training and a two-week music-supported training.

RESULTS

It was revealed that 27.5% of the Roma women in the experimental group had the pap smear test after the intervention, and there was a significant difference in the mean scores of the awareness of cervical cancer and screening and the factors of the Health Belief Model Scale for Cervical Cancer and Pap Smear Test compared to the pre-intervention. It was found that the intervention had a significant effect at the level of 77.9% in reducing the perceived barriers to the pap smear test (p < 0.001).

CONCLUSION

It was found that the music-supported education program based on the Health Belief Model positively affected the awareness and health beliefs of Roma women about cervical cancer and screening.

TRIAL REGISTRATION

The study was registered with the U.S.National of Medicine Clinical Trials Registry (NCT04756440 -15.08.2020).

The TFRC as a prognostic biomarker and potential therapeutic target in cervical cancer: a preliminary study

Background

Early detection and treatment of CIN or early-stage cervical cancer lead to better clinical outcomes compared to treating advanced-stage patients. Thus, specific biomarkers for the diagnosis and prognosis of CIN and early-stage cervical cancer should be urgently explored.

Methods

We analyzed tumor based on genes closely related to OS in the database with GSE63514, GSE7803, GSE9750 and TCGA data sets, the top 20 core genes were screened out. Notably, transferrin receptor (TFRC) emerged as a prioritized candidate due to its dual role in cellular iron homeostasis and oncogenic signaling. However, the exact role of TFRC in the development and progression of cervical cancer remains unclear. We then used various bioinformatics methods and mathematical models to analyze those data, aiming to investigate the clinical significance of TFRC in cervical cancer and illustrate its association with tumor immunity. In addition, the molecular function and mechanisms of TFRC were revealed by gene ontology, Kyoto Encyclopedia of Genes and Genomes, and gene set enrichment analysis. Immunohistochemistry was employed to assess TFRC protein expression in 19 cervical cancers, 16 HSILs and 15 normal cervical tissues.

Results

TFRC was highly expressed in CESC in the TCGA and GSE9750 datasets. Meanwhile, the expression of TFRC was correlated with pathological stage, lymph node metastasis, malignant degree of cervical lesions and HPV infection status. Our analysis confirmed that TFRC expression was higher in CESC tissues compared to normal cervical tissues, and it was also elevated in HSIL relative to normal tissues, as determined by IHC staining. Increased TFRC expression was linked to decreased overall survival (OS) (p = 0.024), disease-specific survival (DSS) (p = 0.009), and progression-free interval (PFI) (p = 0.007) in CESC patients. In different clinical stages, pathological T stages, and pathological N stages, higher TFRC expression was significantly associated with worse survival for OS and DSS. We constructed a nomogram model, TFRC contributed significantly to the prognosis and exhibited good predictive power for the OS and the DSS. Finally, we confirmed that immunosuppression in cervical cancer is closely related to high TFRC expression.

Conclusions

TFRC exhibits significant diagnostic and prognostic value in cervical cancer.

Experiences of Self-Collected Human Papilloma Virus (HPV) Testing Among Women Aged 20 to 65 Years in Ho Chi Minh City, Vietnam

Background/Objectives: To assess the correct sampling rates and self-collection satisfaction levels among female residents aged 25 to 64 years during first-time HPV testing in the communities of Ho Chi Minh City. Methods: An observational study was conducted on self-collection for HPV testing in communities from January to December 2024. The study employed a probability proportional to size sampling method, involving self-collected sampling and post-collection direct interviews. Results: The data show that 99.9% [95% CI = 0.99-1] of 775 women successfully collected their own samples during a first-time HPV testing process. The self-collection satisfaction rate was 80.4% [95% CI = 0.77-0.83]. Conclusions: Self-collected sampling for HPV testing has a very high success rate in communities. Moreover, women who feel confident in self-collection tend to have higher satisfaction rates with this new method. Therefore, self-collection sampling should be widely adopted for early cervical cancer screenings to test for high-risk HPV. It is essential to provide careful instructions and mobilization to encourage women's confidence in performing self-collections.

Analysis of 19,116 cases of human papillomavirus infection and subtype distribution in Sanmen, Zhejiang Province, China

OBJECTIVE

To analyze the prevalence and subtype distribution of human papillomavirus (HPV) infection in Sanmen County, Zhejiang Province, China, and the correlation between ThinPrep cytologic test (TCT) results.

METHODS

A retrospective analysis was conducted on the demographic and clinical data of patients who underwent HPV typing and TCT at Sanmen People's Hospital from January 2020 to December 2022. The HPV infection rate in the region was calculated, and the HPV infection status among patients in different age groups and departments was compared, as well as the relationship between different HPV types and TCT results.

RESULTS

A total of 19,116 patients were included in the study. The overall HPV infection rate was 16.3%, single-type of infection accounted for 82.7% and multiple-type of infection accounted for 17.3%, with a high-risk type infection rate of 12.6% and a low-risk type infection rate of 2.7%. The top six HPV types in positive cases were type 52 at 24.3%, type 58 at 13.4%, type 53 at 12.5%, type 81 at 9.0%, type 16 at 7.3%, and type 68 at 5.8%. The results revealed a significant difference in HPV infection rates among age groups, with the < 25-year group having the highest infection rate at 21.1%. The proportion of abnormal TCT results was 8.0%, there was no significant difference in the comparison of abnormal TCT results among age groups, and no cases of high-grade squamous intraepithelial lesions were found in the < 25-year group. HPV type 16 had the highest positivity rate in cases of high-grade squamous intraepithelial lesion group.

CONCLUSION

HPV infection in the region is mainly single-type. The most common types were high-risk HPV 52, 58, and 53, with the highest HPV infection rate found in the < 25-year group. High-grade squamous intraepithelial lesion were closely related to infections with HPV 16, 58, 52, and 18.

HPV Genotype Trends in Iran: Necessity for a Reevaluation of Prevention Strategies

INTRODUCTION

Human papillomavirus (HPV) genotyping is critical for preventing and managing HPV-related health issues, including cancers. This study re-evaluates HPV genotype trends in Iran to inform prevention strategies.

MATERIALS AND METHODS

A cross-sectional analysis of HPV genotyping data from individuals tested at the ACECR Khorasan Razavi molecular laboratory in Iran (2016-2022) was conducted, with a forecast of genotype trends through 2027.

RESULTS

Among 5009 female patients, 40.4% tested positive for HPV (mean age: 32 ± 8.77 years), with a significant upward trend in positivity over time (tau = 0.905, p = 0.0069). HPV 6, 11, 16, 31, 53, and 54 showed significant increases (p < 0.01), while HPV 66, 84, 67, and 35 exhibited notable trends (p < 0.05). HPV 18 and 33 had marginal trends (p = 0.065, p = 0.052), and HPV 68, 70, and 82 remained stable. Linear regression indicated a non-significant decline in low-risk HPV cases (R = 0.703, p = 0.078) and negligible change in high-risk cases (R = 0.052, p = 0.912). Forecasts predicted increases in HPV 84, 54, 43, 42, and 26, with HPV 6 projected to decrease significantly. HPV 44, 73, and 33 were expected to remain stable.

CONCLUSION

While low-risk HPV cases may decline, the trend lacks statistical significance, and high-risk HPV cases show no change. These findings underscore the need for targeted prevention strategies in Iran, particularly for high-risk genotypes, to reduce the burden of HPV-related cancers. Further research is essential to validate these trends and refine public health interventions.

Evaluating TGF-β1 gene expression and promoter polymorphism in cervical cancer progression

This study aims to investigate the TGF-β1 gene, which has significant prognostic value for early detection and diagnosis of cervical cancer, as well as TGF-β1 gene mRNA and protein expression and the association of promoter region (-509 C>T) polymorphisms with cervical cancer (CC) development. Transcriptome analysis, immunohistochemistry, and RT-PCR were conducted to determine the gene expression of TGF-β1. The PCR-SSCP and Sanger sequencing methods were employed to test and validate the TGF-β1 -509C>T promoter polymorphism in cervical squamous cell carcinoma in comparison to control samples. TGF-β1 is a cytokine that plays a role in tumorigenesis as well as physiological and pathological processes. It appeared as one of the most over-expressed genes identified through the clariom D transcriptome microarray, which describes its role in cancer progression. The results showed a significant TGF-β1 upregulation in CC compared to normal cervical tissue was confirmed using immunohistochemistry and real-time PCR. The levels of TGF-β1 were also determined using a receiver operating characteristic (ROC) curve to distinguish diseased from normal individuals. TGF-β1 ROC showed good selectivity in distinguishing malignant CC from non-malignant cervical tissues. The -509 C>T promoter polymorphism in the TGF-β1 gene is found to be significantly more common in the disease group, and in-silico analysis (using the AliBaba2.0 gene regulation tool) confirms its correlation to the loss of myogenin transcription factor binding site, may resulting in TGF-β1 overexpression.

Triage of women with positive HPV: comparing DNA ploidy analysis with HPV 16/18 genotyping and cervical cytology

Background

Cervical cancer screening primarily uses the human papillomavirus (HPV) test with partial genotyping (HPV 16/18) and liquid-based cytology using ThinPrep cytology test (TCT) to triage women with a positive HPV test. Although quantitative DNA ploidy analysis has shown reliability, its integration into screening guidelines as a triage test, compared to partial genotyping and TCT, has not been fully established. The objective of the study is to evaluate the clinical utility of DNA ploidy analysis as a triage test for women with a positive HPV test in primary screening, comparing it to HPV 16/18 genotyping and TCT.

Methods

We retrospectively analyzed data from 335 women aged ≥18 years who participated in a cervical cancer screening program at Shanghai Ruijin Hospital and underwent triage using HPV 16/18, TCT, and DNA ploidy testing. The sensitivities and specificities of these methods, both individually and combined, were evaluated.

Results

The test showed sensitivities and specificities of 35.4% and 76.1% for HPV 16/18, 29.2% and 88.2% for TCT, and 93.8% and 92.7% for DNA ploidy, respectively. Combining these tests improved outcomes, with DNA ploidy plus HPV 16/18 genotyping showing enhanced sensitivity and high specificity. Notably, DNA ploidy alone identified high-grade squamous intraepithelial lesions (HSIL) and cervical cancer with a higher detection rate and lower positivity rate in triage than HPV 16/18 and TCT.

Conclusions

DNA ploidy analysis demonstrated superior specificity and sensitivity in the triage of women with positive HPV test results, offering a more effective alternative for detecting high-grade lesions and cervical cancer. These findings support the potential of integrating DNA ploidy into current cervical cancer screening protocols to enhance triage effectiveness and reduce unnecessary colposcopy referrals.

APOC1, transcriptionally regulated by FOXM1, promotes M2 macrophage polarization and cervical cancer progression

BACKGROUND

Cervical cancer (CC) is a common malignant tumor in women. M2 macrophages are associated with tumor growth, metastasis, and immunosuppression. Apolipoprotein C1 (APOC1) has been confirmed as an oncogene in CC. However, the role and mechanism of APOC1 in CC progression and M2 macrophages remain to be elucidated.

METHODS

The effects of APOC1 on CC cell malignant phenotypes were examined by CCK-8, colony formation, wound healing, and transwell assays in vitro and mice transplant tumor model in vivo. M2 macrophage polarization was assessed by qRT-PCR and flow cytometry assays. The interaction between APOC1 and forkhead box M1 (FOXM1) was determined using chromatin immunoprecipitation (ChIP) and luciferase reporter assays.

RESULTS

The expression of APOC1 and FOXM1 was upregulated in CC tissues and cells. Knockdown of APOC1 or FOXM1 resulted in the inhibition of cell proliferation, migration, invasion, and EMT. Moreover, the polarization of M2 macrophages was attenuated when APOC1 or FOXM1 was silenced. Mechanistically, FOXM1 transcriptionally activated APOC1 by binding to its promoter. Furthermore, overexpression of APOC1 reversed the inhibitory effects of FOXM1 knockdown on cell proliferation, metastasis, and M2 macrophage polarization. Additionally, the knockdown of APOC1 reduced tumor growth and M2 macrophage polarization in mice.

CONCLUSION

FOXM1/APOC1 axis is involved in the progression of CC and the regulation of M2 macrophages polarization, bringing new hope to the treatment of CC.

Pidotimod plus recombinant human interferon α-2b suppository boosts HPV clearance in high-risk patients following loop electrosurgical excision procedure

OBJECTIVE

To assess human papillomavirus (HPV) negative conversion, vaginal microecological recovery, and serum inflammatory factor levels in patients with high-risk HPV infection treated with pidotimod (PDT) plus recombinant human interferon α-2b (rh-IFN-α2b) suppository after loop electrosurgical excision procedure (LEEP).

METHODS

A total of 97 patients with high-risk HPV infection who underwent LEEP from March 2020 to May 2023 were retrospectively selected. Among these cases, 45 treated with rh-IFN-α2b suppository were assigned as control group, while the other 52 treated with PDT + rh-IFN-α2b suppository were assigned as combined group. HPV negative conversion, side effects (fever, nausea, abdominal discomfort, and vaginal burning sensation), vaginal microecology recovery (vaginal pH, Nugent score), and serum inflammatory markers (interleukin [IL]-4, IL-12, and interferon [IFN]-γ) were compared between the two groups. Furthermore, univariate and multivariate analyses were performed to identify factors associated with failure to achieve negative conversion.

RESULTS

The combined group demonstrated a higher HPV negative conversion rate, treatment response rate, and vaginal microecological recovery rate (lower vaginal pH and Nugent score) compared to the control group. Also, post-treatment IL-4 levels were lower, while IL-12 and IFN-γ were higher in the combined group. The side effects in the two groups were similar. Univariate and multivariate analyses revealed that HPV type and treatment modality were associated with HPV negative conversion failure, but were not independent predictors.

CONCLUSIONS

PDT plus rh-IFN-α2b suppository can effectively improve HPV negative conversion, accelerate vaginal microecology recovery, and modulate serum inflammatory responses in high-risk HPV patients after LEEP.

Persistence and clearance rates of human papillomaviruses in a cohort of women treated or not treated for cervical dysplasia in northwest Ethiopia

Persistence of high-risk Human papillomaviruses (HR-HPV) infection increases the risk of precancerous lesions development. The aim of this study was to assess the persistence and clearance rate of HPV infection. A prospective cohort study was conducted between January and December 2023 among patients attending gynecology unit of FHCSH in Bahir Dar, northwest Ethiopia. Out of 297 study participants, 95 women with HPV infected and cytological abnormalities were followed; of these 93.7% were HPV positive at the baseline study. Of which, 46.1% did not receive treatment, the rest 53.9% were treated. Among the women without treatment, HPV persistence and clearance rates were 65.9% and 34.1% respectively while persistence rate of 46.3% and clearance rate of 53.7% were observed in 12-month follow up period. Among women who received treatment, HPV persistence rate of 45.8% and clearance rate of 54.2% were recorded in six while persistence rate of 33.3% and clearance rate of 66.7% were observed in 12- month follow up period. The findings of our study indicated that the high persistence rate and low clearance rate of HPV infection. Detection of persistent HPV infection without treatment or after treatment should be considered as the main risk factor for the development or recurrence of cervical neoplasia.

Prevalence and genotype distribution of human papillomavirus in individuals referred to a laboratory in Urmia, Iran

BACKGROUND AND AIM

Human papillomavirus (HPV) is a major contributor to sexually transmitted infections, especially common in sexually active populations. Although the majority of HPV infections resolve naturally, certain cases can develop into different types of cancer. This study focused on evaluating the prevalence and distribution of HPV genotypes across males and females of different age groups who visited a laboratory in Urmia, Iran.

MATERIALS AND METHODS

Samples from the genital area were obtained from participants in the study. DNA extraction was performed using the Favorgen extraction kit (Favorgen, Taiwan), followed by genotyping through Real-Time PCR. Genotypes were determined using the MehrViru HPV genotyping kit (MehrViru, Iran). Additionally, demographic details, including age, were analyzed in conjunction with the statistical virological data.

RESULTS

Between 2022 and 2023, a total of 447 individuals, including both referred and routine visitors, attended the laboratory, comprising 431 females and 16 males. Of these, 195 tested positive for HPV, resulting in an overall prevalence rate of 43.6%. Among the positive cases, 90 individuals (46.2%) were infected with a single HPV genotype, while 105 cases (53.8%) had multiple genotype infections. The most common genotypes identified were HPV-6 (41.0%), HPV-16 (15.4%), HPV-56 (10.8%), and HPV-90 (10.8%). The least genotype identified was HPV-43, which was detected in 5 cases (2.6%). Additionally, our analysis revealed that women under 30 who tested positive were predominantly infected with the LR genotype, a pattern also seen in the four men in the same age group, all of whom were infected with the LR genotype.

CONCLUSION

Our findings underscore the significant presence of HPV among both females and males visiting the laboratory in Urmia, particularly in individuals under 30 years old. The identification of HPV-6 and HPV-16 as the most prevalent genotypes highlights the importance of age-specific intervention strategies. Although vaccination programs cover HPV-6 and HPV-16, HPV-56 is not included, which underscores the need for comprehensive screening and preventive measures to address the potential long-term impacts of HPV-related diseases.

Knowledge and awareness of cervical cancer and prevention measures among female students in Poland: a cross-sectional, decade apart study

OBJECTIVE

Cervical cancer (CC) is a global health issue, despite the availability of effective preventive measures. The objective of this investigation was to evaluate the comprehension of CC and its preventive measures among 17-25-year-old female students living in southern Poland, to compare the results with the data obtained in 2012 and to propose actionable recommendations for improving the current state of affairs.

METHODS

The study collected data from 464 female students during a ten-month period in 2022 using a pre-validated tool developed by our group, CCKP-64 categorized into sections: personal information, basic CC knowledge, risk factor assessment, awareness of primary and secondary prevention, and sources of information.

RESULTS

The 98.92% of participants were aware of CC, 42.24% linked it to an infection. Genetic factors and human papillomavirus (HPV) infection were commonly identified as risk factors. Most of the participants (81.90%) knew about the Pap smear and planned to undergo the test (74.74%). The most common sources of information were the Internet (81.68%), family and friends (46.77%), and medical staff (42.89%). Comparison with the 2012 cohort indicated a decrease in awareness of HPV vaccine existence (69.85% vs. 53.23%, p<0.001) and cytological examination (91.21% vs. 81.90%, p<0.001), but increase in percentage of vaccinated population (9.35% vs. 19.43%, p=0.001).

CONCLUSION

The insufficient knowledge and deteriorating trends in CC prevention among young women over the last decade are concerning. The proportion of vaccinated women remains unsatisfactory. Measures to enhance awareness of national reimbursed HPV vaccination program are necessary.

Identifying optimum implementation for human papillomavirus self-sampling in underserved communities: A systematic review

OBJECTIVE

To review the existing evidence to identify the optimum methods for implementing human papillomavirus self-sampling to increase screening uptake for underserved groups.

SETTING

Specific groups are less likely to participate in cervical screening. These include individuals from low socioeconomic status groups, ethnic minority groups, younger age groups (25-29), older age groups (≥50), with a physical disability, with a learning disability and with an LGBTQ+ identity. The advent of human papillomavirus self-sampling for cervical screening presents an opportunity to promote equitable access to screening. Implementation for human papillomavirus self-sampling can vary, for example, opt-out or opt-in approaches. However, it is unclear which of these is the best method of offering human papillomavirus self-sampling to underserved groups.

METHODS

Six databases were searched through May 2023. Studies comparing cervico-vaginal human papillomavirus self-sampling provision using different implementation strategies with the standard screening pathway in underserved groups were identified. A narrative synthesis was conducted.

RESULTS

In total, 4574 studies were identified; 25 studies were included, of which 22 were from high-income countries. Greater uptake was found for offering human papillomavirus self-sampling compared to standard clinician-based sampling. Directly mailing human papillomavirus self-sampling kits to participants resulted in higher uptake of screening than using an 'opt-in' approach or standard recall in low socioeconomic status and ethnic minority groups, and older women. Strategies that used community health workers or educational materials increased uptake in ethnic minority and low socioeconomic status groups.

CONCLUSIONS

Directly mailing human papillomavirus self-sampling kits to low socioeconomic status groups, ethnic minority groups and older women has the potential to increase uptake of human papillomavirus self-sampling. Using community health workers to offer human papillomavirus self-sampling should be considered for ethnic minority and low socioeconomic status groups. Further research exploring the preferences of younger women is needed.

Investigation of the Potency of KALA and REV Cell-Penetrating Peptides for In Vitro/In Vivo Delivery of an HPV Multiepitope DNA Construct

Developing human papillomavirus (HPV) therapeutic DNA vaccines requires an effective delivery system, such as cell-penetrating peptides (CPPs). In the current study, the multiepitope DNA constructs harboring the immunogenic and conserved epitopes of the L1, L2, and E7 proteins of HPV16/18 (pcDNA-L1-L2-E7 and pEGFP-L1-L2-E7) were delivered using KALA and REV CPPs with different properties in vitro and in vivo. Herein, after confirmation of the REV/DNA and KALA/DNA complexes, their stability was investigated against DNase I and serum protease. Then, their entry into HEK-293T eukaryotic cells was analyzed by qualitative and quantitative methods. Finally, anti-tumor effects of the peptide/DNA complexes were investigated in the C57BL/6 mouse model. Based on the obtained data, the REV/DNA and KALA/DNA complexes at the N/P ratio of 5:1 demonstrated successful penetration into HEK-293T cells. Furthermore, in vivo studies represented that the REV/DNA (survival rate: 75%) and KALA/DNA (survival rate: 50%) complexes provided significant protection against C3 tumors in mice. Indeed, REV CPP exhibited a higher survival rate and lower tumor volume than KALA CPP, 50 days after the C3 challenge. These findings represented the potential of KALA and REV CPPs, especially REV, as promising gene delivery systems for developing HPV therapeutic DNA vaccine candidates.

Cervicovaginal Microbiome: Physiology, Age-Related Changes, and Protective Role Against Human Papillomavirus Infection

Background/Objectives: Persistent high-risk human papillomavirus (HPV) infections are the leading cause of cervical cancer. Developing evidence suggests that the cervicovaginal microbiome plays a significant role in modulating HPV persistence and progression to cervical neoplasia. This review synthesizes the current knowledge on the interplay between the cervicovaginal microbiome and local immunity in HPV infections, emphasizing microbial diversity, immune responses, and potential therapeutic implications. Methods: A thorough review of the literature was performed using Embase, PubMed, Scopus, and Google Scholar, encompassing studies published between 2000 and 2024. Studies examining the composition of the microbiome, immune responses, and HPV-related outcomes were evaluated and synthesized into a comprehensive review. Results: A Lactobacillus-dominant microbiome, particularly with L. crispatus, creates a protective environment through lactic acid production, maintenance of low pH, and anti-inflammatory immune modulation, facilitating HPV clearance. Dysbiosis, often characterized by a dominance of L. iners and overgrowth of anaerobic bacteria, fosters chronic inflammation, cytokine imbalance, and a microenvironment conducive to HPV persistence and progression. Hormonal changes and menopause exacerbate these microbial shifts, increasing the risk of cervical lesions. Studies suggest that cytokine profiles and antimicrobial peptides significantly influence local immune responses, further modulating infection outcomes. Conclusions: The cervicovaginal microbiome is a critical determinant in HPV infection outcomes, with therapeutic potential for modulating the microbiome to enhance immune responses and prevent cervical cancer. Personalized microbiome-targeted therapies may offer a novel avenue for managing HPV and reducing cervical cancer incidence.

Assessment of Knowledge Gaps in Cervical Cancer Screening and HPV Vaccination Among Chinese Women: A Comprehensive Population-Based Study

Background

While studies on cervical cancer screening (CCS) and human papillomavirus (HPV) vaccine uptake exist in China, few have examined both within populations participating in CCS programs.

Methods

This cross-sectional, population-based survey included 37,797 women aged 18-64 years attending gynecological outpatient clinics. Participants completed a questionnaire assessing CCS awareness and participation. Additionally, HPV vaccine knowledge was investigated in a sub-sample of 17,010 women aged <45 years.

Results

The mean age of participants was 45.06 years (SD: 8.52). The mean CCS knowledge score was 63.13%, with 52.53% reporting prior CCS uptake. Factors associated with lower CCS knowledge included low monthly household income, lack of rural cooperative medical insurance, low literacy, not having received CCS within the past 3 years, unmarried status, and childbirth history. A strong positive correlation was observed between CCS knowledge and adherence to CCS recommendations (Spearman correlation coefficient: 0.708, p < 0.01). Awareness of the HPV vaccine was reported by 48.33% of participants, with HPV vaccine knowledge positively correlated with CCS awareness (Spearman correlation coefficient: 0.629, p < 0.01). CCS knowledge partially mediated the relationship between HPV vaccine knowledge and willingness to vaccinate, with a mediating effect size of 21.16%.

Conclusion

Integrated health education efforts targeting CCS and HPV vaccine awareness are essential. Empowering women to understand the significance of HPV vaccination and regular CCS participation can enhance cervical cancer prevention strategies.

Evaluating HPV Viral Load and Multiple Infections for Enhanced Cervical Cancer Risk-Based Assessment

Human papillomavirus (HPV) is a major cause of cervical cancer, a significant health concern worldwide. Despite advances in screening methods, including the Pap test and the HPV DNA test, limitations remain in accurately predicting which HPV infections will progress to cervical intraepithelial neoplasia (CIN) and, eventually, invasive cancer. This study evaluates the usefulness in real life of assessing HPV viral load and the presence of multiple HPV genotypes in enhancing the diagnostic accuracy of triage in cervical cancer screening. A retrospective analysis was performed on 55 formalin-fixed paraffin-embedded cervical samples collected from women who underwent colposcopy with a biopsy or conization at San Martino Hospital, Genova, Italy, between January and June 2021. Histological diagnoses were compared with molecular analyses (HPV genotyping, viral load quantification and co-infection) using a multiplex real-time PCR platform. Of the samples analyzed, 56.4% were HPV DNA positive, while 40% tested negative. The molecular analysis identified more HPV-negative cases than the histological analysis (p < 0.05). Higher viral loads and HPV co-infections were more frequent in high-grade CIN lesions. These markers may help identify patients at an elevated risk for persistent infections and cancer progression. These findings support the potential of integrating HPV viral load and genotype co-infection assessments into routine cervical cancer screening protocols to improve early detection and reduce overtreatment and unnecessary interventions.

Predicting the risk of high-grade precancerous cervical lesions based on high-risk HPV typing in Changsha China

BACKGROUND

Persistent infection with high-risk human papillomavirus (HPV) is a significant risk factor for cervical cancer. HPV typing and cytology are conducted in women of appropriate age to assess the risk of cervical lesions and to guide the need for further diagnostic procedures such as colposcopy, cervical biopsy, or treatment. This article explores methods to predict the risks of high-grade precancerous cervical lesions based on high-risk HPV typing.

METHODS

We conducted a retrospective analysis of HPV typing data from 158,565 women, including 19,707 who underwent ThinPrep cytologic testing (TCT), 7,539 who had colposcopy examinations, and 4,762 who had biopsies. We evaluated the sensitivity, specificity, and risk parameters of high-grade lesions associated with high-risk HPV types.

RESULTS

(1) The overall prevalence of HPV infection was 17.89%, with the most prevalent types being HPV52 (4.44%), HPV58 (2.10%), HPV53 (1.96%), HPV81 (1.85%), HPV42 (1.75%), and HPV16 (1.44%). (2) The sensitivity and specificity of detecting high-grade lesions in TCT, colposcopy, and biopsy, based on high-risk HPV typing, demonstrated a strong linear correlation with the infection rate of each type. (3) HPV16 was confirmed to have a higher risk of CIN2 + in biopsies using a self-defined risk parameter. (4) The top five HPV types with the highest PPVs and pathogenicity risks in biopsies were HPV45, HPV16, HPV58, HPV33, and HPV18.

CONCLUSION

In Changsha, China, HPV52, HPV58, and HPV53 were the most prevalent and contributed significantly to high-grade lesions. After adjusting for infection rates, a self-defined risk parameter was proposed as a measure of the intrinsic risks of high-grade lesions associated with high-risk HPV types. Focused monitoring of prevalent high-risk HPV types such as HPV45, HPV16, HPV58, HPV33, and HPV18, which show the highest pathogenicity risks, is recommended in our region.

The Relationship Between Cervicovaginal Infection, Human Papillomavirus Infection and Cervical Intraepithelial Neoplasia in Romanian Women

Cervical intraepithelial neoplasia (CIN) is a premalignant cervical condition closely linked to persistent high-risk HPV infection, a major risk factor for cervical cancer. This study aims to investigate the relationship between cervicovaginal infections, HPV infection, and CIN development in 94 Romanian women with cervical lesions. Comprehensive assessments included HPV genotyping, cytology, colposcopy, and histopathology. In 53.20% of cases, vaginal infections were identified, with Candida albicans most frequently associated with HPV. Histopathology revealed 48.94% low-grade CIN, 42.55% high-grade CIN, and 8.51% invasive carcinoma. There was a strong correlation between high-risk HPV types (especially HPV 16 and 18), colposcopic findings, histopathology, and age. This study emphasizes the mutual effect of cervicovaginal infections and HPV infection in increasing the risk of developing CIN and cervical cancer among Romanian women. Persistent infection with high-risk HPV types, particularly HPV 16 and 18, has been confirmed as a primary driver of CIN and cervical cancer progression.

Impact of Hormonal Contraceptives on HPV Dynamics in Adolescent Girls and Young Women: Insights from a Randomized Controlled Sub-Study in South Africa

Objectives

Human papillomavirus (HPV) is the leading cause of cervical cancer, with adolescent girls and young women (AGYW) in sub-Saharan Africa carrying a disproportionately high burden of infection. Hormonal contraceptives may influence HPV acquisition, persistence, and clearance, but evidence remains inconclusive. This sub-study aimed to evaluate the impact of different hormonal contraceptives on HPV prevalence and genotype distribution in AGYW.

Methods

Ninety-eight HIV-seronegative AGYW aged 15-19 years from South Africa were randomized to receive one of three hormonal contraceptive methods: norethisterone enanthate (Net-EN) injectable, combined oral contraceptive pills (COCPs), or the etonorgesterol/ethinyl estradiol combined contraceptive vaginal ring (CCVR). Cervical DNA samples were collected at baseline and after 16 weeks for HPV genotyping using the HPV Direct Flow Chip test. HPV prevalence, persistence, clearance, and acquisition were analyzed across contraceptive methods.

Results

At baseline, HPV prevalence was high (94.9%), with no differences among contraceptive arms. After 16 weeks, HPV prevalence remained high (89.5%) across groups. No significant differences were observed in overall HPV prevalence or genotype distribution by contraceptive method. Longitudinal analysis revealed that AGYW using Net-EN tended to have a higher cumulative number of high-risk HPV (HR-HPV) genotypes that cleared whereas those using CCVR acquired more HR-HPV types and had greater HR-HPV persistence compared to other groups.

Conclusions

This study highlights the high burden of HPV among South African AGYW. However, different hormonal contraceptive methods did not significantly influence HR-HPV dynamics.

Deep learning for predicting prognostic consensus molecular subtypes in cervical cancer from histology images

Cervical cancer remains the fourth most common cancer among women worldwide. This study proposes an end-to-end deep learning framework to predict consensus molecular subtypes (CMS) in HPV-positive cervical squamous cell carcinoma (CSCC) from H&E-stained histology slides. Analysing three CSCC cohorts (n = 545), we show our Digital-CMS scores significantly stratify patients by both disease-specific (TCGA p = 0.0022, Oslo p = 0.0495) and disease-free (TCGA p = 0.0495, Oslo p = 0.0282) survival. In addition, our extensive tumour microenvironment analysis reveals differences between the two CMS subtypes, with CMS-C1 tumours exhibit increased lymphocyte presence, while CMS-C2 tumours show high nuclear pleomorphism, elevated neutrophil-to-lymphocyte ratio, and higher malignancy, correlating with poor prognosis. This study introduces a potentially clinically advantageous Digital-CMS score derived from digitised WSIs of routine H&E-stained tissue sections, offers new insights into TME differences impacting patient prognosis and potential therapeutic targets, and identifies histological patterns serving as potential surrogate markers of the CMS subtypes for clinical application.

Beliefs and Perceptions in Attending the Cervical Screening: The COMUNISS Project Experience

BACKGROUND

Several studies highlighted that tailored health communication interventions improve cervical screening participation, vaccination coverage, and awareness about self-sampling benefits. The "COMUNISS" project was aimed at increasing awareness about cervical cancer prevention, identifying barriers to screening, and promoting screening uptake in under-screened women.

METHODS

A dedicated website with a Q&A session regarding HPV-associated diseases has been set up. Participants were invited to complete a questionnaire to gather demographic information, knowledge about HPV and cervical cancer, and attitudes toward screening based on the Health Beliefs Model (HBM). Women can also require a vaginal self-sampling kit at your home to perform the HPV-DNA analysis.

RESULTS

The website registered over 1000 users over 6 months, and 256 women completed the survey. Nearly half were under-screened. The HBM revealed a high susceptibility and severity perception of diseases, regardless of screening participation, whereas older women declared a high perception of barriers. One-quarter of the women who had requested the self-collection kit returned it for the HPV-DNA testing.

CONCLUSIONS

The project found significant gaps in knowledge regarding extra-cervical HPV-related cancers, interpretation of screening results, and effectiveness of self-collection. These findings highlight the need to plan targeted information campaigns to enhance awareness and adherence to screening programs.

Detection of cervical precancerous lesions and cancer by small-scale RT-qPCR analysis of oppositely deregulated mRNAs pairs in cytological smears

Background

Cervical screening, aimed at detecting precancerous lesions and preventing cancer, is based on cytology and HPV testing. Both methods have limitations, the main ones being the variable diagnostic sensitivity of cytology and the moderate specificity of HPV testing. Various molecular biomarkers are proposed in recent years to improve cervical cancer management, including a number of mRNAs encoded by human genes involved in carcinogenesis. Many scientific papers have shown that the expression patterns of cellular mRNAs reflect the severity of the lesion, and their analysis in cervical smears may outperform HPV testing in terms of diagnostic specificity. However, such analysis has not yet been implemented in broad clinical practice. Our aim was to devise an assay detecting severe cervical lesions (≥HSIL) via analysis of cellular mRNA expression in cytological smears.

Methods

Through logistic regression analysis of a reverse-transcription quantitative PCR (RT-qPCR) dataset generated from analysis of six mRNAs in 167 cervical smears with various cytological diagnoses, we generated a family of linear classifiers based on paired mRNA concentration ratios. Each classifier outputs a dimensionless decision function (DF) value that increases with lesion severity. Additionally, in the same specimens, the HPV genotyping, viral load assessment, diagnosis of cervicovaginal microbiome imbalance and profiling of some relevant mRNAs and miRNAs were performed by qPCR-based methods.

Results

The best classifiers were obtained with pairs of mRNAs whose expression changes in opposite directions during lesion progression. With this approach based on a five-mRNA combination (CDKN2A, MAL, TMPRSS4, CRNN, and ECM1), we generated a classifier having ROC AUC 0.935, diagnostic sensitivity 89.7%, and specificity 87.6% for ≥HSIL detection. Based on this classifier, a two-tube RT-qPCR based assay was developed and it confirmed the preliminary characteristics on 120 cervical smears from the test sample. DF values weakly correlated with HPV loads and cervicovaginal microbiome imbalance, thus being independent markers of ≥HSIL risk.

Conclusion

Thus, we propose a high-throughput method for detecting ≥HSIL cervical lesions by RT-qPCR analysis of several cellular mRNAs. The method is suitable for the analysis of cervical cytological smears prepared by a routine method. Further clinical validation is necessary to clarify its clinical potential.

LINE-1 ORF1p is a Promising Biomarker in Cervical Intraepithelial Neoplasia Degree Assessment

Cervical intraepithelial neoplasia (CIN) represents a spectrum of preinvasive squamous lesions within the cervical epithelium, whose identification is a diagnostic challenge due to subtle histomorphological differences among its categories. This study explores ORF1p, a nucleic acid-binding protein derived from long interspersed nuclear element-1 (LINE-1), as a potential biomarker for enhancing CIN diagnosis. A comprehensive analysis of 143 cervical specimens, encompassing CIN I (n=20), CIN II (n=46), CIN III (n=14), invasive cancer (n=32), and nondysplastic cases (normal cervical epithelia (n=24) and atrophy (n=7) were conducted. ORF1p, Ki67, and p16 expressions were evaluated using immunohistochemistry. ORF1p immunopositivity was detected in the vast majority [110/112 (98.2%)] of dysplastic and neoplastic (CIN and invasive cancer) specimens, whereas 19/24 (79.2%) of normal cervical specimens lacked ORF1p expression. The observed pattern of ORF1p expression showed a progressively increasing extent and intensity with advancing CIN grades. CIN I exhibited mild ORF1p expression in the lower one or two-thirds of the cervical epithelium [14/16 (87.5%)], whereas CIN II demonstrated moderate to strong ORF1p expression spanning the lower two-thirds [29/46 (63.0%)]. Pronounced transepithelial ORF1p immunopositivity characterized CIN III cases [13/14 (92.8%)] and cervical cancer [30/32 (93.8%)]. These findings propose ORF1p as a valuable indicator even for detecting CIN I, effectively discerning them from normal cervical tissue (p < 0.0001). Our findings underscore the potential of ORF1p as an early diagnostic marker for cervical neoplasia.

Decoding impact of human papillomavirus in gynecological oncology: a narrative review

Human papillomavirus (HPV) is a key factor in gynecological oncology. This narrative review investigates the complex connection between HPV and various gynecological cancers. For a comprehensive exploration, we examined the association between persistent HPV infection and cervical cancer and its global prevalence. Beyond the cervix, we navigated the linkages between HPV and other gynecological malignancies, shedding light on vulvar, vaginal, anal, and oropharyngeal cancers. The narrative extends to discuss the critical role of HPV vaccination in preventing these cancers and exploring challenges, controversies, and future perspectives in the field. As we have described the impact of HPV, this review underscores the significance of ongoing research and public health endeavors in shaping the trajectory of gynecological oncology.

Nanoparticles and the Vaginal Microbiota: Diagnostic and Therapeutic Innovations in Human Papilloma Virus-associated Cervical Cancer - A Systematic Review

Cervical cancer (CC) remains a significant global health challenge, with the interplay between microbiome and cancer progression becoming increasingly evident. A comprehensive literature search was conducted across multiple databases, including Embase, NCBI, Google Scholar, Elsevier, Science Direct and PubMed, utilising the specific keywords such as 'cervical cancer', 'cervical microbiome', 'vaginal microbiome', 'Human papillomavirus', 'nanoparticles', 'drug delivery' and 'dysbiosis'. Studies published over the past 15 years were reviewed. A total of 400 articles were identified and 65 research articles were finally included. This systematic approach identified relevant studies, enabling an in-depth analysis of microbial species, such as Parabacteroides, Escherichia, Shigella, Gardnerella and Fusobacterium which are recognised as the potential biomarkers for CC diagnosis and progression. Dysbiosis is characterised by a reduction in helpful bacteria and a proliferation of harmful ones. It is linked to chronic inflammation and human papillomavirus infection, both of which facilitate the CC progression. Advanced nanotechnology presents innovative therapeutic options for CC treatment, enhancing drug delivery systems and targeting tumour cells more effectively. Moreover, incorporating nanocarriers into treatment regimens aims to improve the bioavailability and efficacy of existing therapies, potentially transforming the clinical approaches to CC management. This review highlights the dual role of the microbiome as both a diagnostic and prognostic biomarker and elucidates the potential of nanotechnology in optimising treatment strategies, advocating for further research on microbial interactions in cancer pathology.

Biogenic synthesized CuO nanoparticles and 5-fluorouracil loaded anticancer gel for HeLa cervical cancer cells

Cervical cancer remains a significant health challenge in developing countries are high due to low HPV vaccination rates, delayed diagnosis, and restricted healthcare access. Metal nanomaterials, such as copper oxide (CuO) nanoparticles (NPs), have shown significant promise in cancer therapy due to their ability to induce apoptosis. 5-Fluorouracil (5-Fu) enhances the cytotoxic effect against cervical cancer, working synergistically with CuO NPs to maximize the therapeutic impact while potentially reducing the 5-Fu's systemic side effects. This study explores the synergistic therapeutic potential of green-synthesized CuO NPs combined with 5-Fu in a gel formulation for targeted anticancer activity against HeLa cervical cancer cells. CuO NPs were synthesized using Trichosanthes dioica dried seeds extract and incorporated into a pectin-xanthan gum-based gel. The green-synthesized CuO NPs exhibited a zeta potential of -23.7 mV, a particle size of approximately 26 nm, and spherical morphology. Characterization studies, including FTIR, viscosity, spreadability, pH, and stability assessments, confirmed the gel's suitability for vaginal delivery. In-vitro drug release showed xanthan gum extended the release up to 8 h. The MTT assay revealed PXFCu6 gel's IC50 at 11.82 ± 0.22 μg/mL, significantly more cytotoxic to HeLa cells, being 3.62 times potent than CuO NPs (IC50: 42.8 ± 0.24 μg/mL) and 1.63 times potent than 5-Fu alone (IC50: 19.3 ± 0.49 μg/mL). The antibacterial assay showed no inhibition for the plain gel, but T. dioica-mediated CuO NPs exhibited inhibition of 22.35 ± 4.9 mm. PXFCu6 gel had the more potent inhibition at 52.05 ± 1.37 mm against Escherichia coli growth. The PXFCu6 gel showed better stability at 4 °C, maintaining viscosity, pH, and drug release, unlike 25 °C where a mild degradation occurred. This research highlights the potential of the CuO NPs-5-Fu gel as a novel, effective therapeutic strategy for cervical cancer treatment.

High frequency of HPV high-risk preventable genotypes in Ecuadorian women with invasive cervical cancer

Objective

To determine the distribution of human papillomavirus (HPV) genotypes in invasive cervical cancer samples from Ecuadorian women who attended the Cancer Institute (Sociedad de Lucha Contra el Cáncer - SOLCA).

Methods

Archived formalin-fixed paraffin-embedded (FFPE) cervical cancer tissue samples collected during 2017-2021 were deparaffinized, and nucleic acid extraction and purification was performed using silica columns. The obtained nucleic acids were analyzed using INNO-LiPA® HPV Genotyping Extra II per the manufacturer's specifications. Data were retrieved from records, and HPV genotypes were determined from the FFPE samples.

Results

The study included samples from 190 women diagnosed with invasive cervical cancer, with a median age of 52.78 years. Squamous cell carcinoma accounted for 78.94% of the cases, while 21.05% had adenocarcinoma. Among the 190 samples, 80.53% tested positive for HPV DNA, while 19.47% were negative. The most common genotypes detected were HPV 16 (64.05%), 18 (16.99%), and 58 (6.54%). HPV infection frequency was higher in samples from patients with elementary level education (p < 0.05).

Conclusions

This study provides valuable insights into the distribution of HPV genotypes in invasive cervical cancer samples from Ecuadorian women. The results indicate an elevated presence of HPV 16, HPV 18, and HPV 58, which are vaccine-preventable genotypes.

Oncogenic human papillomavirus infection (HPV 16/18) and associated factors among women in East Gojjam Zone, NorthWest Ethiopia 2021

Background

Human papillomavirus is a common pathogen that infects the skin and mucosal epithelium, is transmitted sexually; causes condylomas or squamous cell carcinomas. Two (16 and 18) of the 150 HPV serotypes are oncogenic types. Studies have been done on the infection by oncogenic human papillomavirus 16/18 and associated factors are found to be very limited in Ethiopia. This study aimed to assess the prevalence of oncogenic human papillomavirus infection (HPV 16/18) and associated factors among women.

Methods

An institutional-based cross-sectional study was conducted among 337 women screened for cervical cancer in two hospitals in East Gojjam Zone from February to April 2021 G.C. Four BSc-qualified nurses who worked in the chosen hospitals collected the data using pretested questionnaire and an HPV test (OncoE6TM Cervical Test) specific to HPV16/18 in cervical swabs. Descriptive analysis was performed to determine the prevalence and a multivariate logistic regression model was used to identify the associated factors of HPV16/18 infection. Finally, statistical significance was declared at P < 0.05.

Results

The prevalence of HPV infection was 14.2% (95% CI: 10.7% -18.1%). The mean age of the respondents was 36.7±9.1 years. Women with the age group of 55-65 years (AOR = 7.91, 95% CI: 1.95-32.09), early initiation of sexual intercourse (AOR = 5.36, 95% CI: 1.58-18.13), history of sexually transmitted infection (STI) (AOR = 3.52, 95% CI: 1.27-9.72), human immunodeficiency virus (HIV) positive status (AOR = 6.8, 95% CI: 1.99-23.54), and number of lifetime sexual partners (AOR = 4.37, 95% CI: 1.15-17.3) were important independent factors associated with the presence of oncogenic HPV infection.

Conclusion and Recommendation

We found a relatively low prevalence of high-risk HPV infection. Age, early initiation of sexual intercourse at less than 18 years, STI of women, being HIV seropositive, and a number of sexual partners were important factors for high-risk HPV infection. Women aged > 46 years, women with early initiation of sex, a history of STI, being HIV positive, and a history of multiple sexual partners should be encouraged to be screened and vaccinated for HPV infection. Wider-ranging studies are also needed in HPV-infected women in association with the cervical lesion.

Human Papillomavirus as Nontraditional Cardiovascular Risk Factor: Fact or Fiction? Part 2

Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and worldwide, with more than 42 million Americans infected with types of HPV that are known to cause disease. While the link between HPV and the development of a variety of cancers has been strongly established, recent literature has demonstrated a potential association between HPV and increased risk of cardiovascular disease. Nevertheless, despite plausible mechanisms for the development of cardiovascular disease with HPV infection, a causative relationship has yet to be firmly established, in part due to potential confounding risk factors between the two. In this 2-part series, we discuss the emerging relationship between HPV and cardiovascular disease. In part 2, we focus on novel risk factors for HPV infection and cardiovascular disease including adverse childhood events, socioeconomic status, and immunosuppression. We conclude with potential prevention and treatment strategies for HPV-related cardiovascular disease, as well as the future direction of the research.

Human papillomavirus self-sampling versus provider-sampling in low- and middle-income countries: a scoping review of accuracy, acceptability, cost, uptake, and equity

Introduction

HPV self-sampling is a relatively new, cost-effective and widely accepted method, however, uptake in LMICs remains limited. We aimed to map out the evidence and identify gaps in accuracy, acceptability, cost, equity and uptake of self-sampling vs. provider-sampling in LMICs.

Methods

We searched: MEDLINE, EMBASE, CINAHL, SCOPUS, Web of Science, and Global Index Medicus, from 1946 to July 2023. Inclusion criteria entailed studies focusing on self-sampling alone or compared to provider-sampling for HPV testing and reporting on at least one outcome of interest (accuracy, acceptability, cost, equity, or uptake). Two authors independently screened titles, abstracts, and full texts, resolving disagreements through discussion. Data was extracted by one reviewer independently, with quality checks by senior authors, and results were synthesised narratively.

Results

Our search yielded 3,739 records, with 124 studies conducted on 164,165 women aged 15-88 years between 2000 and 2023 included. Most studies were from the African region (n = 61, 49.2%). Designs included cross-sectional (n = 90, 81.1%), randomised (n = 5, 4.5%), modelling (n = 4, 3.6%), micro-costing (n = 2, 1.8%), and non-randomised crossover (n = 1, 0.9%) studies. Outcomes included; acceptability (n = 79, 63.7%), accuracy (n = 51, 41.1%), cost (n = 7, 5.6%), and uptake (n = 7, 5.6%). Most studies reported that participants preferred self-sampling, with only a few studies (n = 7, 8.9%) studies favouring provider-sampling. The sensitivity and specificity of self-sampling ranged from 37.5-96.8% and 41.6-100.0%, respectively. One study directly compared the sensitivity and specificity of dry self-collected vs. wet provider-collected sample transportation. Laboratory costs were similar, but overall costs were lower for self-sampling. Uptake was higher for self-sampling in five of the seven studies. Most studies (n = 106) mentioned equity factors like age (n = 69, 65.1%), education (n = 68, 64.2%) and place of residence (n = 59, 55.6%) but no analysis of their impact was provided.

Conclusion

HPV self-sampling is acceptable and cost-effective but, evidence of its accuracy shows varying sensitivity and specificity. Evidence on the accuracy of dry self-collected vs. wet provider-collected sample transportation is limited. Research evaluating HPV self-sampling's accuracy, including comparisons of transportation modes, uptake, the impact of equity factors in LMICs and comparisons with high-income countries is essential to inform cervical cancer screening uptake.

Systematic review registration

https://doi.org/10.17605/OSF.IO/34TUY.

Highly sensitive deep panel sequencing of 27 HPV genotypes in prostate cancer biopsies results in very low detection rates and indicates that HPV is not a major etiological driver of this malignancy

BACKGROUND

Human papillomavirus (HPV) has been proposed to contribute to the carcinogenesis of prostate cancer. However, previous studies have yielded conflicting results. This study aims to add useful information to the ongoing discussion concerning the association between HPV infection and prostate cancer.

METHODS

We used two high-throughput next-generation sequencing (NGS) approaches to detect HPV RNA in malignant and adjacent normal (AN) prostate tissue (cohorts 1 and 2) and HPV DNA from carcinogenic and probably/possibly carcinogenic-classified HPV types (cohort 3) in malignant prostate, AN prostate, and benign prostatic hyperplasia (BPH) tissues.

RESULTS

In total, 0% (cohort 1: 0/83, cohort 2: 0/16) of the malignant prostate tissue samples and 0% (cohort 1: 0/23, cohort 2: 0/8) of the AN prostate tissue samples were positive for HPV RNA. A total of 8.3% (1/12) of the BPH samples, 0% (0/28) of the AN samples, and 0.8% (1/132) of the malignant prostate samples were positive for HPV16 DNA. However, the normalized read count of the HPV16-positive malignant sample was close to the cut-off. In addition, no other carcinogenic-classified HPV types were detected in any of the BPH, AN, or malignant prostate tissue samples.

CONCLUSION

Our study does not support HPV infection as a major contributor to the etiology of prostate cancer.

Design, synthesis, and in vitro and in vivo biological evaluation of triazolopyrimidine hybrids as multitarget directed anticancer agents

In response to the urgent need for new anti-proliferative agents, four novel series of triazolopyrimidine compounds (7a-e, 9a-d, 11a-f, and 13a-e) were synthesized and evaluated for in vitro anticancer efficacy against HCT116, HeLa, and MCF-7 cell lines. Compound 13c emerged as the most potent, with IC50 values of 6.10, 10.33, and 2.42 μM respectively, while 11e and 7c also showed strong activity. In multi-target suppression tests, 13c exhibited the highest inhibition against EGFR, TOP-II, HER-2, and ARO (IC50: 0.087, 31.56, 0.078, and 0.156 μM, respectively). Flow cytometry revealed 13c's ability to suppress the S-phase cell population in MCF-7 cells. In vivo studies of 13c demonstrated significant tumor growth inhibition, comparable to the positive control. Molecular docking studies supported the experimental findings, confirming the binding of the novel motifs to the target enzymes' active sites. This comprehensive evaluation highlights the potential of these triazolopyrimidine compounds, particularly 13c, as promising anticancer agents, warranting further investigation.

Human Papillomavirus as Non-Traditional Cardiovascular Risk Factor: Fact or Fiction? Part 1

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and worldwide, with more than 42 million Americans infected with types of HPV that are known to cause disease. Although the link between HPV and the development of a variety of cancers has been strongly established, recent literature has demonstrated a potential association between HPV and increased risk of cardiovascular disease. Nevertheless, despite plausible mechanisms for the development of cardiovascular disease with HPV infection, a causative relationship has yet to be firmly established, in part due to potential confounding risk factors between the two. In this 2-part series, we discuss the emerging relationship between HPV and cardiovascular disease. In part 1, we focus on the pathophysiology of HPV infection and potential mechanisms for the development of cardiovascular disease.

Navigating the landscape of HPV-associated cancers: From epidemiology to prevention

Human Papillomavirus (HPV) is a widespread infection associated with various cancers, including cervical, oropharyngeal, anal, and genital cancers. This infection contributes to 5 % of global cancer cases annually, affecting approximately 625,600 women and 69,400 men. Cervical cancer remains the most prevalent HPV-linked cancer among females, with the highest incidence seen in low and middle-income countries (LMICs). While most HPV infections are transient, factors such as HPV variants, age, gender, and socioeconomic status influence transmission risks. HPV is categorized into high-risk (HR-HPV) and low-risk types, with strains like HPV 16 and 18 displaying distinct demographic patterns. The intricate pathogenesis of HPV involves genetic and epigenetic interactions, with HPV oncogenes (E6 and E7) and integration into host DNA playing a pivotal role in driving malignancies. Early diagnostics, utilizing HPV DNA testing with surrogate markers such as p16, and advanced molecular techniques like PCR, liquid biopsy, and NGS, significantly impact the management of HPV-induced cancers. Effectively managing HPV-related cancers demands a multidisciplinary approach, including immunotherapy, integrating current therapies, ongoing trials, and evolving treatments. Prevention via HPV vaccination and the inclusion of cervical cancer screening in national immunization programs by conventional Pap smear examination and HPV DNA testing remains fundamental.Despite the preventability of HPV-related cancers, uncertainties persist in testing, vaccination, and treatment. This review article covers epidemiology, pathogenesis, diagnostics, management, prevention strategies, challenges, and future directions. Addressing issues like vaccine hesitancy, healthcare disparities, and advancing therapies requires collaboration among researchers, healthcare providers, policymakers, and the public. Advancements in understanding the disease's molecular basis and clinical progression are crucial for early detection, proper management, and improved outcomes.

Comprehensive insights into human papillomavirus and cervical cancer: Pathophysiology, screening, and vaccination strategies

This article provides an in-depth review of the Human Papillomavirus (HPV), a predominant etiological factor in cervical cancer, exploring its pathophysiology, epidemiology, and mechanisms of oncogenesis. We examine the role of proteins, DNA methylation markers, and non-coding RNAs as predictive biomarkers in cervical cancer, highlighting their potential in refining diagnostic and prognostic practices. The evolution and efficacy of cervical cancer screening methods, including the Papanicolaou smear, HPV testing, cytology and HPV test, and colposcopy techniques, are critically analyzed. Furthermore, the article delves into the current landscape and future prospects of prophylactic HPV vaccines and therapeutic vaccines, underscoring their significance in the prevention and potential treatment of HPV-related diseases. This comprehensive review aims to synthesize recent advances and ongoing challenges in the field, providing a foundation for future research and clinical strategies in the prevention and management of cervical cancer.

Advances and challenges in the use of liquid biopsy in gynaecological oncology

Ovarian cancer, endometrial cancer, and cervical cancer are the three primary gynaecological cancers that pose a significant threat to women's health on a global scale. Enhancing global cancer survival rates necessitates advancements in illness detection and monitoring, with the goal of improving early diagnosis and prognostication of disease recurrence. Conventional methods for identifying and tracking malignancies rely primarily on imaging techniques and, when possible, protein biomarkers found in blood, many of which lack specificity. The process of collecting tumour samples necessitates intrusive treatments that are not suitable for specific purposes, such as screening, predicting, or evaluating the effectiveness of treatment, monitoring the presence of remaining illness, and promptly detecting relapse. Advancements in treatment are being made by the detection of genetic abnormalities in tumours, both inherited and acquired. Newly designed therapeutic approaches can specifically address some of these abnormalities. Liquid biopsy is an innovative technique for collecting samples that examine specific cancer components that are discharged into the bloodstream, such as circulating tumour DNA (ctDNA), circulating tumour cells (CTCs), cell-free RNA (cfRNA), tumour-educated platelets (TEPs), and exosomes. Mounting data indicates that liquid biopsy has the potential to improve the clinical management of gynaecological cancers through enhanced early diagnosis, prognosis prediction, recurrence detection, and therapy response monitoring. Understanding the distinct genetic composition of tumours can also inform therapy choices and the identification of suitable targeted treatments. The main benefits of liquid biopsy are its non-invasive characteristics and practicality, enabling the collection of several samples and the continuous monitoring of tumour changes over time. This review aims to provide an overview of the data supporting the therapeutic usefulness of each component of liquid biopsy. Additionally, it will assess the benefits and existing constraints associated with the use of liquid biopsy in the management of gynaecological malignancies. In addition, we emphasise future prospects in light of the existing difficulties and investigate areas where further research is necessary to clarify its rising clinical capabilities.

Frequency of Human Papillomavirus Genotypes among Women with Genital Wart Using Molecular Hybridization Methods

Background & Objective

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide, which can lead to virus-related cancers. This study aimed to investigate the frequency of HPV genotypes in women with genital warts referred to available laboratories in Tehran by molecular hybridization method.

Methods

This cross-sectional descriptive study was conducted on the genital warts of 67 women aged 20-50, who were referred to the clinics of Afshar, Namad, Mani, and Al-Mohammed in Tehran province. Viral DNA was extracted using Add prep genomic DNA extraction kit, and genotyping was studied using HPV Direct Flow CHIP Kit. Data were analyzed by GraphPad Prism software.

Results

HPV was reported to be positive in all cases. The most common low-risk genotype involved was type 6, with 30 cases (44.77%), and the most common high-risk genotype involved was type 16, with 4 cases (5.97%) in the total population. Among the patients examined, there were 16 cases with multiple infections.

Conclusion

The results of this study showed that low-risk genotypes may be responsible for majority of the genital warts. High-risk genotypes and simultaneous infection with several genotypes could also be common in genital wart samples. Therefore, controlling HPV infection is important, especially in patients with high-risk genotypes. HPV genotyping should be considered in diagnosis and prevention of HPV-related cancers.

Roles of lncRNAs related to the p53 network in breast cancer progression

The p53 is a crucial tumor suppressor and transcription factor that participates in apoptosis and senescence. It can be activated upon DNA damage to regulate the expression of a series of genes. Previous studies have demonstrated that some specific lncRNAs are part of the TP53 regulatory network. To enhance our understanding of the relationship between lncRNAs and P53 in cancers, we review the localization, structure, and function of some lncRNAs that are related to the mechanisms of the p53 pathway or serve as p53 transcriptional targets.

Environment and gynaecologic cancers

In the current era, environmental factors are well established as major causative agents for all cancers especially lung and breast cancer. We sought to review the current available literature on the topic pertaining to gynaecologic cancers. Although a few factors are well established in literature, others need more research to conclude.

Cervical cancer screening service utilisation and related factors among women on antiretroviral therapy in public health facilities of Asella town, Ethiopia, cross-sectional study

BACKGROUND

Cervical cancer is the predominant form of cancer in Ethiopia, accounting for the majority of malignant cases. Women account for two-thirds of cancer-related deaths in the country. Cervical cancer screening (CCS) can help prevent disease development, but screening rates are unacceptably low. The greatest number of women were in the most vulnerable group, and the availability of wheal data on their use of CCSs was limited. This study aimed to evaluate the use of CCS and the factors that influence its use among HIV-positive women receiving antiretroviral therapy at public health facilities.

METHODS

This study used a cross-sectional study design. A total of 396 (97.5%) HIV-positive women participated in this study between March 10 and May 30, 2023. Participants enrolled in public health facilities in Asella town were selected through systematic random sampling, and data were collected through on-site interviews using a pretested, structured questionnaire. The data were analysed using the Statistical Package for Social Science, Version 26. Logistic regression analysis was used to identify the determining factors.

RESULTS

The findings from this study indicated that 30.3% of individuals used cervical cancer screening services. Those women who had knowledge about cervical cancer had a 2.54 times greater likelihood of receiving CCS than those who were not informed (adjusted odds ratio [AOR] = (2.54; 95% confidence interval [CI]: 1.42-4.56). Women with a history of sexually transmitted diseases were twice as likely to use CCS as those without such a history (AOR = 2.05, 95% CI = 1.13-3.73). Furthermore, women with a positive attitude towards CCS were found to be significant predictors of utilisation, showing a greater than threefold greater likelihood of using these services (AOR = 3.21; 95% CI: 1.78-5.81).

CONCLUSIONS

The proportion of HIV-positive women who underwent cervical cancer screening (CCS) was significantly lower than the recommended guideline of 80%. To enhance the uptake of screening among women with HIV, healthcare professionals should focus on enhancing awareness about cervical cancer, improving attitudes towards CCS, and advancing knowledge about the disease. Healthcare providers' collaboration with both government and nongovernmental stakeholders plays a crucial role in addressing the challenges of accessibility and attendance at screening services.

Unraveling the role of EPHA2 in regulating migration and immunomodulation processes in cervical cancer: exploring the synergic effect of 17β-estradiol on cancer progression

Cervical cancer remained among the most prevalent cancers in women. Erythropoietin-producing hepatocellular A2 (EPHA2) is overexpressed in many cancers, including cervical cancer, and the mechanism by which it regulates cervical cancer progression is not yet fully understood. Exosomes are extracellular vesicles that carry information in the form of biomolecules, deliver it to the recipient cell, and play a vital role in cellular communication. 17β-Estradiol is the natural female steroid hormone with the greatest estrogenic activity, and it induces cell death in cancer. In this study, we investigated the function of EPHA2 in cervical cancer migration and immunomodulation and the presence of EPHA2 in the cervical cancer serum-derived exosome. A knockdown of EPHA2 (KD-EPHA2) in cervical cancer reduces cancer cell migration by regulating the CD113/Ezrin pathway. Furthermore, EPHA2 exhibited significant involvement in immunomodulation by orchestrating IL-6-mediated signalling cascades, including the AKT-mTOR and JAK-STAT pathways. Immune infiltration analysis revealed a correlation between EPHA2 expression in cervical cancer and the infiltration of various immune cell populations. KD-EPHA2 enhances the 17β-Estradiol inhibitory effect on cell proliferation and migration during cancer progression. In summary, our study revealed that EPHA2 is overexpressed in cervical cancer and plays a vital role in cancer cell migration and immunomodulation, and 17β-Estradiol, along with KD-EPHA2, enhances the inhibitory effect on cancer cell migration and proliferation.

The mutual interplay between NTRK fusion genes and human papillomavirus infection in cervical cancer progression (Review)

Cervical cancer is a significant global health concern, with a substantial portion of cases attributed to human papillomavirus (HPV) infection. Recent advancements in molecular profiling have identified distinct subtypes of cervical cancer based on their genomic alterations. One such subgroup is neurotrophic tropomyosin receptor kinase (NTRK) fusion-positive cervical cancers, characterized by gene fusions involving the NTRK genes. Although both NTRK fusion genes and HPV infections are independently recognized as significant risk factors in cervical cancer, their interplay and mutual effects on cancer progression are not yet fully understood. The present review is the first of its kind to explore the potential interplay between NTRK fusion genes and HPV infections. It surveys in detail how their combined effect can influence the signaling pathways during cervical cancer development and progression. Moreover, the present study discussed the clinical features, histopathological examinations, treatment procedures and follow-up outcomes of NTRK-fusion gene-positive cervical cancer. The present review may help in the understanding of the management and treatment of such rare, lethal and resistant cervical cancers.

The immune microenvironment of cancer of the uterine cervix

While several treatment choices exist for cervical cancer, such as surgical therapy, chemotherapy, and radiotherapy, some patients will still show poor prognosis. HPV infection is a principal factor for cervical cancer development, from early inflammation to proliferation, angiogenesis, and neoplastic growth. While HPV T-cell responses exist, the tumor seems to evade the immune system upon its tolerance. The latter suggests the existence of a confluent tumor microenvironment responsible for the evasion tactics employed by the neoplasm. Therefore, novel biomarkers governing prognosis and treatment planning must be developed, with several studies tackling the significance of the tumor microenvironment in the genesis, development, proliferation, and overall response of cervical cancer during neoplastic processes. This review aims to analyze and contemplate the characteristics of the tumor microenvironment and its role in prognosis, progression, evasion, and invasion, including therapeutic outcome and overall survival.

Anal carcinoma - exploring the epidemiology, risk factors, pathophysiology, diagnosis, and treatment

Anal carcinoma is a relatively rare tumor that accounts for approximately 2% of gastrointestinal malignancies and less than 7% of anorectal cancers. Most anal tumors originate between the anorectal junction and the anal verge. Risk factors for the disease include human papillomavirus infection, human immunodeficiency virus, tobacco use, immunosuppression, female sex, and older age. The pathogenesis of anal carcinoma is believed to be linked to human papillomavirus-related inflammation, leading to dysplasia and progression to cancer. Squamous cell carcinoma is the most common type of anal tumor, with an annual incidence of approximately 1 to 2 per 100000 persons. Treatment regarding anal cancer has emerged over time. However, chemoradiation therapy remains the mainstay approach for early localized disease. Patients with metastatic disease are treated with systemic therapy, and salvage surgery is reserved for disease recurrence following chemoradiation. This article aims to provide background information on the epidemiology, risk factors, pathology, diagnosis, and current trends in the management of anal cancer. Future directions are briefly discussed.

miR-218-5p, miR-124-3p and miR-23b-3p act synergistically to modulate the expression of NACC1, proliferation, and apoptosis in C-33A and CaSki cells

BACKGROUND

In cervical cancer (CC), miR-218-5p, -124-3p, and -23b-3p act as tumor suppressors. These miRNAs have specific and common target genes that modulate apoptosis, proliferation, invasion, and migration; biological processes involved in cancer.

METHODS

miR-218-5p, -124-3p, and -23b-3p mimics were transfected into C-33A and CaSki cells, and RT-qPCR was used to quantify the level of each miRNA and NACC1. Proliferation was assessed by BrdU and apoptosis by Annexin V/PI. In the TCGA and The Human Protein Atlas databases, the level of NACC1 mRNA and protein (putative target of the three miRNAs) was analyzed in CC and normal tissue. The relationship of NACC1 with the overall survival in CC was analyzed in GEPIA2. NACC1 mRNA and protein levels were higher in CC tissues compared with cervical tissue without injury.

RESULTS

An increased expression of NACC1 was associated with lower overall survival in CC patients. The levels of miR-218-5p, -124-3p, and -23b-3p were lower, and NACC1 was higher in C-33A and CaSki cells compared to HaCaT cells. The increase of miR-218-5p, -124-3p, and -23b-3p induced a significant decrease in NACC1 mRNA. The transfection of the three miRNAs together caused more drastic changes in the level of NACC1, in the proliferation, and in the apoptosis with respect to the individual transfections of each miRNA.

CONCLUSION

The results indicate that miR-218-5p, -124-3p, and -23b-3p act synergistically to decrease NACC1 expression and proliferation while promoting apoptosis in C-33A and CaSki cells. The levels of NACC1, miR-218-5p, -124-3p, and -23b-3p may be a potential prognostic indicator in CC.

A Pilot Study Based on the Correlation Between Whole Exome and Transcriptome Reveals Potent Variants in the Indian Population of Cervical Cancer

Cervical malignancy (CC) is the 2nd most prevalent malignancy among females, leading to cancer mortality. Primary detection of CC tumors results in an improved prognosis. CC is a malignant gynecological tumor, with few treatment options. New diagnostic and therapeutic agents are required to expand patient survival and quality of life. If CC tumors can be found at an early stage, the prognosis is much brighter. New diagnostic and therapeutic agents are needed to increase patient survival and quality of life. In this work, we performed whole-exome sequencing utilizing V5 (Illumina platform) 10 samples, 5 control and 5 CC tumour tissue, and we compared the results with transcriptome studies. KMT2C variations were shown to be among the most vicious in this analysis. From an Indian viewpoint, we found a plethora of SNVs and mutations, including those with known, unknown, and possible effects on health. Based on our findings, we know that the KMT2C gene is on chr. Seven and in exon 8, all three recognized variants are missense, synonymous, coding synonymous, non-coding variants, and GnomAD MAF (- 0.05). The variation at position (7:152265091, T > A, SNV 62478356) in KMT2C is unique, potent, and pathogenic. The missense coding transcript CIQTNF maps to chromosome 7 and displays T > C SNV. In addition, we performed single strand conformational polymorphism analysis on 64 samples and further confirmed them using Sanger sequencing to understand and verify the mutations. KMT2C shows a log FC value of - 1.16. Understanding emerging harmful mutations from an Indian viewpoint is facilitated by our bioinformatics-based, extensive correlation studies of WES analysis. Potentially harmful and new mutations were found in our preliminary analysis; among these ten top mutated genes, KMT2C and CIQTNF were altered in ten cases of CC with an Indian phenotype.

Unveiling the hidden link: fungi and HPV in cervical lesions

Background

Cervical cancer, primarily driven by high-risk human papillomavirus (HR-HPV) infection, ranks as the second most common cancer globally. Understanding combined infections' role, including Cervical fungi, is crucial in cervical carcinogenesis. This study aims to explore the potential correlation between HR-HPV, cervical fungi, and cervical cancer, while adjusting for various factors.

Methods

The study population comprised patients undergoing colposcopy and conization due to abnormal cervical screening results. Clinical data including age, gravidity, HPV (human papillomavirus) genotypes, cervical pathology, and p16/Ki67 expression were extracted. Cervical TCT (ThinPrep Pap Test) and HPV testing are utilized for screening cervical lesions, with fungal presence suggested by TCT results. 5,528 participants were included in this study. Statistical analyses investigated associations between HPV/fungi co-infection and cervical lesions, employing multinomial logistic regression and interaction analysis.

Results

Co-infection with fungi and HPV may decrease the risk of cervical lesions compared to HPV infection alone. In the co-infection group, compared with HPV infection alone, the risk of low-grade squamous intraepithelial lesions (LSIL) was reduced by 27% (OR = 0.73, 95% CI: 0.59-0.90), the risk of high-grade squamous intraepithelial lesions (HSIL) was reduced by 35% (OR = 0.65, 95% CI: 0.51-0.82), and the risk of cervical cancer was reduced by 43% (OR = 0.57, 95% CI: 0.35-0.92). The interaction analysis revealed a negative interaction between fungal and HPV infections in the development of cervical cancer (RERI = -6.25, AP = -0.79, SI = 0.52), HSIL (RERI = -19.15, AP = -0.37, SI = 0.72) and LSIL (RERI = -1.87, AP = -0.33, SI = 0.71), suggesting a sub-additive effect, where the combined effect of the two infections was less than the sum of their individual effects. This indicates that fungal infection may attenuate the promoting effect of HPV on cervical lesions. In exploring the potential mechanism, we found that the co-infection group had significantly lower p16 positivity (54.6%) compared to the HPV-only group (60.2%) (p = 0.004), while there was no statistically significant difference in Ki67 positivity.

Conclusion

This study unveils the intricate relationship between cervical fungi and HPV in cervical lesions. Co-infection with fungi and HPV against cervical lesions compared to HPV infection alone, indicating a novel clinical interaction. Lower p16 positivity in co-infection hints at a protective mechanism, urging further exploration.

Association between the social vulnerability index and breast, cervical, and colorectal cancer screening rates in Rhode Island

BACKGROUND

Cancer screening is effective in reducing the burden of breast, cervical, and colorectal cancers, but not all communities have appropriate access to these services. In this study, we aimed to identify under-resourced communities by assessing the association between the Social Vulnerability Index (SVI) with screening rates for breast, cervical, and colorectal cancers in ZIP-code tabulation areas (ZCTAs) in Rhode Island.

METHODS

This study leveraged deidentified health insurance claims data from HealthFacts RI, the state's all-payer claims database, to calculate screening rates for breast, cervical, and colorectal cancers using Healthcare Effectiveness Data and Information Set measures. We used spatial autoregressive Tobit models to assess the association between the SVI, its four domains, and its 15 component variables with screening rates in 2019, accounting for spatial dependencies.

RESULTS

In 2019, 73.2, 65.0, and 66.1% of eligible individuals were screened for breast, cervical, and colorectal cancer, respectively. For every 1-unit increase in the SVI, screening rates for breast and colorectal cancer were lower by 0.07% (95% CI 0.01-0.08%) and 0.08% (95% CI 0.02-0.15%), respectively. With higher scores on the SVI's socioeconomic domain, screening rates for all three types of cancers were lower.

CONCLUSION

The SVI, especially its socioeconomic domain, is a useful tool for identifying areas that are under-served by current efforts to expand access to screening for breast, cervical, and colorectal cancer. These areas should be prioritized for new place-based partnerships that address barriers to screening at the individual and community level.

Prevalence of HPV Genotypes among Greek Women in Association with Their Potential to Cause Precancerous Lesions

The escalating global rates of precancerous lesions associated with human papillomavirus (HPV) types not targeted by current vaccines underscore the need to explore the prevalence of HPV types within the Greek female population and their involvement in precancerous lesion development. In the current study, we enrolled a cohort of 253 women aged 18 to 65 years, residing in Greece, who underwent routine screening in three tertiary care referral hospitals. Each participant completed a demographic questionnaire. An HPV DNA test was administered using the VisionArray® HPV kit (ZytoVision GmbH) to qualitatively detect and genotype 41 clinically relevant HPV genotypes. Of all 253 women examined, 114 (45.1%) tested positive for HPV DNA. The primary type detected was HPV51 (high-risk), present in 21 women (8.3% of the total), followed by HPV54 (low-risk) in 17 women (6.7%); HPV16 (high-risk) ranked third, identified in 14 women (5.5%). Among the HPV-positive women, 65 were positive for high-risk HPV types (57% of HPV-positive women) and were referred for colposcopy and cervical biopsy. These procedures identified 24 women with cervical intraepithelial neoplasia 1 (CIN1) lesions and 2 with cervical intraepithelial neoplasia 2 (CIN2) lesions. The most prevalent HPV type among women with CIN1 lesions was HPV16, found in nine (37.5%) women, while HPV51 ranked second, identified in six (25%) women. Both women with CIN2 lesions tested positive for HPV16, whereas one of them was also tested positive for HPV45. Our study is the first to report the prevalence of HPV51 among HPV-positive women in the Greek female population. This highlights the need for further research to fully understand the potential of HPV types not covered by current vaccines, such as HPV51, to cause high-grade lesions or cervical cancer.