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Studies primarily assessed dietary supplements including calcium, zinc, iron, selenium, carotenoids, and vitamins A, B12, C, D, E, and K. Findings suggest potential protective roles across stages of HPV infection, cervical dysplasia, and invasive disease; however, evidence quality remains limited, warranting further well-designed investigations for clinical 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question does the review address about micronutrients and HPV-related disease?","Question",{"text":63,"@type":64},"It clarifies how micronutrients, minerals, and vitamins may affect the course of HPV infection and the development of cervical cancer, using studies focused on dietary supplements.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which dietary supplements were included as primary study objectives?",{"text":68,"@type":64},"The review included studies evaluating supplements such as calcium, zinc, iron, selenium, carotenoids, and vitamins A, B12, C, D, E, and K.",{"name":70,"@type":61,"acceptedAnswer":71},"What overall conclusion does the review draw about micronutrients and cervical cancer risk?",{"text":72,"@type":64},"Different micronutrients showed a potential protective role by acting at multiple stages of HPV infection, cervical dysplasia progression, and invasive disease 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\nFilippo Alberto Ferrari 1, Francesca Magni 1, Mariachiara Bosco 1, Giulia Biancotto 1, Pier Carlo Zorzato 1, Antonio Simone Lagan 2, Vito Chiantera 2, Ricciarda Raffaelli 1, Massimo Franchi 1, Stefano Uccella 1 and Simone Garzon 1, *  \nCitation: Ferrari, F.A.; Magni, F.; Bosco, M.; Biancotto, G.; Zorzato, P.C.; Laganà, A.S.; Chiantera, V.; Raffaelli, R.; Franchi, M.; Uccella, S.; et al. The Role of Micronutrients in Human Papillomavirus Infection, Cervical Dysplasia, and Neoplasm. Healthcare 2023, 11, 1652. [https://](https://)[ ](https://)[doi.org/10.3390/healthcare11111652](doi.org/10.3390/healthcare11111652)  \nAcademic Editor: Edward J. Pavlik  \nReceived: 20 April 2023  \nRevised: 28 May 2023  \nAccepted: 31 May 2023  \nPublished: 5 June 2023  \nCopyright: © 2023 by the authors. 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://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37126 Verona, Italy  \n2 Unit of Gynecologic Oncology, ARNAS “Civico-Di Cristina-Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy  \n* Correspondence: [simone.garzon@univr.it](simone.garzon@univr.it)  \nAbstract: There is evidence that diet and nutrition are modifiable risk factors for several cancers. In recent years, attention paid to micronutrients in gynecology has increased, especially regarding Human papillomavirus (HPV) infection. We performed a review of the literature up until December 2022, aiming to clarify the effects of micronutrients, minerals, and vitamins on the history of HPV infection and the development of cervical cancer. We included studies having as their primary objective the evaluation of dietary supplements, in particular calcium; zinc; iron; selenium; carotenoids; and vitamins A, B12, C, D, E, and K. Different oligo-elements and micronutrients demonstrated a potential protective role against cervical cancer by intervening in different stages of the natural history of HPV infection, development of cervical dysplasia, and invasive disease. Healthcare providers should be aware of and incorporate the literature evidence in counseling, although the low quality of evidence provided by available studies recommends further well-designed investigations to give clear indications for clinical practice.  \nKeywords: human papillomavirus; cervical dysplasia; cervical cancer; micronutrients; cancer prevention  \n1. Introduction  \nPapillomaviruses are double-stranded DNA viruses with a particular tropism for squamous epithelium. More than 200 human papillomaviruses (HPVs) have been identified and classified in “high-risk HPV”(HR-HPV) and “low-risk HPV” types according to their cancerogenic potential [1] . HPV infections are associated with different types of lesions, such as benign proliferative lesions (warts), as well as precursor lesions with the ability to progress to high-grade neoplasia and invasive cancer, including cervical, anal, penile, vulvar, vaginal, and oropharyngeal tumors [1,2] .  \nCervical cancer (CC) is a significant public health issue affecting women worldwide, with approximately 565,000 new cases and 280,000 deaths annually [3] . A consistent association between HR-HPVs and CC has been established, and persistent infection is the main etiological factor of CC [4] . The International Agency for Research on Cancer (IARC) classified HPV 16, 18, 31, 33, 35,45, 51, 52, 56, 58, 59, 66, and 68 as HR-HPVs, being found in 99.7% of CCs [5] . In the cervical tissue, HPV infection can induce various degrees of prem","cbCaiuGtvl5HQyON","https://ap.wps.com/l/cbCaiuGtvl5HQyON","pdf",709968,16,"English","# Introduction\n# Micronutrients and mechanisms in HPV-related disease\n# Evidence from dietary supplement studies\n# Clinical implications and future research","[{\"question\":\"What question does the review address about micronutrients and HPV-related disease?\",\"answer\":\"It clarifies how micronutrients, minerals, and vitamins may affect the course of HPV infection and the development of cervical cancer, using studies focused on dietary supplements.\"},{\"question\":\"Which dietary supplements were included as primary study objectives?\",\"answer\":\"The review included studies evaluating supplements such as calcium, zinc, iron, selenium, carotenoids, and vitamins A, B12, C, D, E, and K.\"},{\"question\":\"What overall conclusion does the review draw about micronutrients and cervical cancer risk?\",\"answer\":\"Different micronutrients showed a potential protective role by acting at multiple stages of HPV infection, cervical dysplasia progression, and invasive disease development.\"}]","The Role of Micronutrients in Human Papillomavirus Infection, Cervical Dysplasia, and Neoplasm | PDF",1790250644]