[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-367591-105":59,"doc-detail-367591-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","human-papillomavirus-and-other-relevant-issues-in-cervical-cancer-pathogenesis","Human Papillomavirus and Other Relevant Issues in Cervical Cancer Pathogenesis","","Cervical cancer remains a major malignancy among women worldwide, with a majority of cases linked to high-risk human papillomavirus (HPV). Increasing evidence suggests that HPV alone may not fully explain cancer development, as additional factors contribute to carcinogenic progression. Beyond established risks such as smoking and poor nutritional status, studies associate cervical cancer with other viral infections including HIV and HSV-2, and with changes in cervicovaginal bacterial communities. Estrogen and estrogen receptors are also implicated, potentially influencing both cancer promotion and the vaginal microenvironment. These interacting, partly preventable elements may shape the progression of cervical neoplastic lesions.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/human-papillomavirus-and-other-relevant-issues-in-cervical-cancer-pathogenesis/367591/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/human-papillomavirus-and-other-relevant-issues-in-cervical-cancer-pathogenesis/367591.png","ImageObject",300,407,{"name":92,"@type":93},"Putri","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What role does high-risk HPV play in cervical cancer?","Question",{"text":113,"@type":114},"High-risk HPV is detected in most cervical cancer cases and is considered a major factor in disease etiology. However, evidence indicates HPV infection alone may not be sufficient for cancer development.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which additional infections are linked with cervical cancer development?",{"text":118,"@type":114},"Studies associate cervical cancer with other viral infections, including HIV and herpes simplex virus type 2 (HSV-2). These infections may influence the pathological processes leading to malignancy.",{"name":120,"@type":111,"acceptedAnswer":121},"How do vaginal bacteria and estrogen relate to cervical carcinogenesis?",{"text":122,"@type":114},"Different bacterial species can alter the biochemical characteristics of the cervicovaginal environment, potentially protecting against or worsening cancer-related processes. Estrogen is also linked to cancer promotion and to the vaginal microenvironment, and reports suggest an association between estrogen and HPV in cervical cancer development.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},367591,1790407681,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},962085571259,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Review  \nHuman Papillomavirus and Other Relevant Issues in Cervical Cancer Pathogenesis  \nAmitabha Ray  \nAcademic Editor: Marco Ciotti  \nReceived: 31 March 2025  \nRevised: 28 May 2025  \nAccepted: 5 June 2025  \nPublished: 10 June 2025  \nCitation: Ray, A. Human Papillomavirus and Other Relevant Issues in Cervical Cancer Pathogenesis. Int. J. Mol. Sci. 2025, 26, 5549. [https://](https://)[ ](https://)[doi.org/10.3390/ijms26125549](doi.org/10.3390/ijms26125549)  \n[Copyright:](Copyright:) © 2025 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) .  \nSchool of Health Professions, D’Youville University, 320 Porter Ave, Buffalo, NY 14201, USA; [rayam@dyc.edu](rayam@dyc.edu); Tel.: +1-(716)-829-8243  \nAbstract: Cancer of the uterine cervix (cervical cancer) is a leading cancer among women worldwide, although its incidence has been reducing in many developing nations. In the majority of cervical cancer cases, the presence of high-risk human papillomavirus (HPV) is usually detected. However, a growing body of evidence currently considers that exclusive HPV infection may not be sufficient for cancer development. Apart from certain common risk factors for cervical cancer, like poor nutritional status and smoking, many studies documented an association with other viral infections, such as human immunodeficiency virus (HIV) and herpes simplex virus type 2 (HSV-2) . Similarly, vaginal bacterial populations perhaps play a key role in cervical cancer. It may be worth mentioning that different bacterial species can immensely influence (either protecting or adversely) the biochemical characteristics of the cervicovaginal environment—for example, Lactobacillus crispatus, Gardnerella vaginalis, and Chlamydia trachomatis. As a result, chronic infections with unfavorable microorganisms (other than HPV) may affect the pathological processes of malignancy. On the other hand, the cervix is an estrogen-sensitive organ like the corpus uteri (i.e., the body of the uterus) . Estrogen and different estrogen receptors are implicated in the development and promotion of various cancers, including endometrial cancer. A number of reports also suggest a close association between estrogen and HPV in the development of cervical cancer. Furthermore, estrogen is linked with the characteristics of the vaginal microenvironment including bacteria. Therefore, several of the abovementioned factors (some are preventable) could play an important role in the progression of cervical neoplastic lesions.  \nKeywords: cervical lesions; HPV; social factors; tobacco; hormones; cervicovaginal bacteria  \n1. Introduction  \nCancer of the uterine cervix (or cervical cancer) is the fourth most common cancer among women worldwide, but there is a wide geographical variation in incidence rates. Recently, we noticed a decreasing trend in this cancer burden, while higher incidence rates have been recorded in countries such as Eswatini (Swaziland), Lesotho, and Zimbabwe [1,2] . In cervical cancer, women of lower socioeconomic status are usually affected, and human papillomavirus (HPV) infection possibly plays a major role in the etiology of this disease [3] . As per the Centers for Disease Control and Prevention (CDC), approximately 91% of cervical cancer cases are associated with any HPV type. It may be worth mentioning that at least 14 types (i.e., high-risk types) out of more than 200 types of HPV are believed to cause malignant transformation. However, two special types (HPV-16 and-18) are frequently detected in cervical precancerous lesions (dysplasia/cervical intraepithelial neoplasia or CIN) as well as in full-blown cancer. According to the World Health Organization (WHO), these two HPV types are responsible for 70% of cervical","cbCaikCXI1UOVbju","https://ap.wps.com/l/cbCaikCXI1UOVbju","pdf",1715583,46,"English","# Introduction\n## Risk Factors","[{\"question\":\"What role does high-risk HPV play in cervical cancer?\",\"answer\":\"High-risk HPV is detected in most cervical cancer cases and is considered a major factor in disease etiology. However, evidence indicates HPV infection alone may not be sufficient for cancer development.\"},{\"question\":\"Which additional infections are linked with cervical cancer development?\",\"answer\":\"Studies associate cervical cancer with other viral infections, including HIV and herpes simplex virus type 2 (HSV-2). These infections may influence the pathological processes leading to malignancy.\"},{\"question\":\"How do vaginal bacteria and estrogen relate to cervical carcinogenesis?\",\"answer\":\"Different bacterial species can alter the biochemical characteristics of the cervicovaginal environment, potentially protecting against or worsening cancer-related processes. Estrogen is also linked to cancer promotion and to the vaginal microenvironment, and reports suggest an association between estrogen and HPV in cervical cancer development.\"}]","Human Papillomavirus and Other Relevant Issues in Cervical Cancer Pathogenesis | PDF",1790171529,116]