Association between cervical intraepithelial neoplasia progression and cervicovaginal microbiota status - narrative review.

In 2022, an estimated 660 000 women were diagnosed with cervical cancer worldwide and about 350 000 women died from the disease. Human papillomavirus (HPV) infection is one of the most common sexually transmitted infections. However, only a small percentage of high-risk (HR) HPV infections progress to cervical precancer and cancer. In this study, we presented the role of the cervicovaginal microbiome(CVM) in the natural history of HPV infection. Non-viral factors associated with the outcomes of HR-HPV infections have not been fully elucidated. While smoking, hormonal contraceptive use, and parity are associated with developing precancer and cancer, systemic and local immune responses are thought to be important for clearance and control of infection. In addition, specific host immune regulatory alleles are associated with risk of cervical cancer development. There is a strong association between changes in vaginal microbiota and persistent HPV infection, and improving vaginal microbial environment would reduce the risk of developing cervical cancer.