Prevention of human papillomavirus-associated cervical disease in the 21st century
- Authors: Ansarova S.M.1, Basalova J.V.2, Heydarova A.E.1, Grineva A.A.2, Obukhova E.P.1, Romanenko M.S.2, Raevskii K.P.3
-
Affiliations:
- Kirov Military Medical Academy
- North-Western State Medical University named after I.I. Mechnikov
- Lomonosov Moscow State University
- Issue: Vol 31, No 3 (2025)
- Pages: 279-288
- Section: Reviews
- Submitted: 08.01.2025
- Accepted: 05.02.2025
- Published: 11.06.2025
- URL: https://medjrf.com/0869-2106/article/view/643669
- DOI: https://doi.org/10.17816/medjrf643669
- EDN: https://elibrary.ru/HJBWJD
- ID: 643669
Cite item
Abstract
Human papillomavirus (HPV) is the primary pathogen involved in the development of cervical cancer. HPV infection is widespread worldwide. Comprehensive prevention of high-risk oncogenic HPV infection is the main strategy for reducing the incidence of cervical cancer. Raising awareness of the issue, expanding vaccination coverage, developing modern vaccines and diagnostic methods, and increasing public education all contribute to a more rapid achievement of this goal.
This review presents the latest data on current HPV prevention and diagnostic methods, as well as future prospects for addressing this issue in the near term. It highlights recent findings from both Russian and international studies. The review analyzes current approaches to the issue and provides statistics on the prevalence, morbidity, and mortality of cervical cancer in the Russian Federation and other countries. A consistent downward trend in the incidence of cervical cancer has been observed in the countries that have implemented screening and HPV vaccination programs. The main risk factors are identified, including those related to the virus itself and to individual lifestyle. Key mechanisms of HPV-driven oncogenesis are presented, along with preventive screening programs aimed at detecting dysplastic changes and preventing the development of invasive cancer. The currently approved vaccines worldwide are discussed in terms of efficacy and safety, as well as ongoing research on new vaccine development.
Full Text

About the authors
Sabina M. Ansarova
Kirov Military Medical Academy
Email: Sansarova@bk.ru
ORCID iD: 0009-0004-5899-8464
Russian Federation, Saint Petersburg
Julia V. Basalova
North-Western State Medical University named after I.I. Mechnikov
Email: uliabasalova@gmail.com
ORCID iD: 0009-0006-6372-063X
Russian Federation, Saint Petersburg
Aida Elshan kyzy Heydarova
Kirov Military Medical Academy
Email: Gdrvd16@gmail.com
ORCID iD: 0009-0009-1991-149X
Russian Federation, Saint Petersburg
Alina A. Grineva
North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: Grinva.lina@gmail.com
ORCID iD: 0009-0007-4338-9174
SPIN-code: 9222-1003
Russian Federation, Saint Petersburg
Elena P. Obukhova
Kirov Military Medical Academy
Email: Yelena.obukhova.2001@list.ru
ORCID iD: 0009-0002-4962-1505
Russian Federation, Saint Petersburg
Marina S. Romanenko
North-Western State Medical University named after I.I. Mechnikov
Email: Marina.romanenko.2001@mail.ru
ORCID iD: 0009-0009-2213-3887
Russian Federation, Saint Petersburg
Kirill P. Raevskii
Lomonosov Moscow State University
Email: Raevskiikp@my.msu.ru
ORCID iD: 0000-0002-9939-3443
SPIN-code: 9133-3802
Russian Federation, Moscow
References
- Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. doi: 10.3322/caac.21660 EDN: MRLXRI
- Kravtsova EA, Tsyganov MM, Litviakov NV, Ibragimova MK. HPV-associated cervical cancer: Current status and prospects. Acta Biomedica Scientifica. 2023; 8(3):42–54. doi: 10.29413/ABS.2023-8.3.4 EDN: FVUTDN
- Stolbovoy AV, Islim N, Loiko IE, et al. Issues in the treatment of cervix uteri. Clinical Review for General Practice. 2024;5(7): 59–68. doi: 10.47407/kr2024.5.7.00448 EDN: JOOAMY
- Marochko KV, Artymuk NV, Breus AV. Cervical squamous intraepithelial lesions: A comparison of diagnostic approaches. Fundamental and Clinical Medicine. 2024;9(1):33–41. doi: 10.23946/2500-0764-2024-9-1-33-41 EDN: BSHVYU
- Kuleshova SV, Khabarov SV, Denisova OV, Leshkina GV. The problem of false negative results of cervical cancer cytology screening: Problems, solutions, prospects. Journal of New Medical Technologies. 2024;31(3):37–46. doi: 10.24412/1609-2163-2024-3-37-46 EDN: VBUXDM
- Klinyshkova TV. Cervical screening strategies: a modern perspective. Russian Bulletin of Obstetrician-Gynecologist. 2023;23(4):20–26. doi: 10.17116/rosakush20232304120 EDN: FEHYEY
- Gameiro SF, Mymryk JS. Special issue “Human Papillomavirus Clinical Research: From Infection to Cancer”. J Clin Med. 2022;11(14):4225. doi: 10.3390/jcm11144225 EDN: NGPDDV
- de Martel C, Georges D, Bray F, et al. Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis. Lancet Glob Health. 2020;8(2):e180–e190. doi: 10.1016/S2214-109X(19)30488-7 EDN: DNISFW
- Wang R, Pan W, Jin L, et al. Human papillomavirus vaccine against cervical cancer: Opportunity and challenge. Cancer Lett. 2020;471:88–102. doi: 10.1016/j.canlet.2019.11.039 EDN: GVNGKS
- Ono A, Koshiyama M, Nakagawa M, et al. The preventive effect of dietary antioxidants on cervical cancer development. Medicina (Kaunas). 2020;56(11):604. doi: 10.3390/medicina56110604 EDN: QLJRTJ
- Anokhova LI, Belokrinitskaya TE, Belozertseva EP, Maslova TM. An innovative approach to the treatment of high-risk HPV patients using allokin-alpha. Meditsinskiy Sovet. 2021;(13):199–205. doi: 10.21518/2079-701X-2021-13-199-205 EDN: FPARHC
- Volgareva GM. Papillomaviral carcinogenesis. Major achievements and certain challenge’s part 1. General notions of papillomaviruses. Human papillomaviruses-associated cancers. Russian Journal of Biotherapy. 2020;19(1):6–12. doi: 10.17650/1726-9784-2019-19-1-6-12 EDN: NVVIMN
- Artemova OI. Factors in the formation of neoplastic processes in the cervix. Doctor.Ru. 2023;22(5):75–80. doi: 10.31550/1727-2378-2023-22-5-75-80 EDN: RAVWZE
- Przybylski M, Pruski D, Millert-Kalińska S, et al. Expression of E4 protein and HPV major capsid protein (L1) as a novel combination in squamous intraepithelial lesions. Biomedicines. 2023;11(1):225. doi: 10.3390/biomedicines11010225 EDN: FBLNZI
- Kamal M, Lameiras S, Deloger M, et al. Human papilloma virus (HPV) integration signature in cervical cancer: identification of MACROD2 gene as HPV hot spot integration site. Br J Cancer. 2021;124(4):777–785. doi: 10.1038/s41416-020-01153-4 EDN: UTIREL
- Zhukova AB. Squamous intraepithelial lesions of the cervix: a modern view of etiology, pathogenesis, and diagnosis. Journal of Obstetrics and Womens Diseases. 2019;68(6):87–98. doi: 10.17816/JOWD68687-98 EDN: PKMEDZ
- Mantoani PT, Siqueira DR, Jammal MP, et al. Immune response in cervical intraepithelial neoplasms. Eur J Gynaecol Oncol. 2021;42(5):973. doi: 10.31083/j.ejgo4205146 EDN: WEKCOA
- Lugović-Mihić L, Cvitanović H, Djaković I, et al. The influence of psychological stress on HPV infection manifestations and carcinogenesis. Cell Physiol Biochem. 2021;55(S2):71–88. doi: 10.33594/000000395 EDN: ABUOXX
- Begliarzade SA, Mukhametova RR, Zhao B. Prospects for comprehensive screening and treatment of cervical cancer. Creative Surgery and Oncology. 2024;14(1):60–68. doi: 10.24060/2076-3093-2024-14-1-60-68 EDN: GOXJID
- WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention [Internet]. Geneva: World Health Organization; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572317/
- Volgareva GM. Papillomaviral carcinogenesis. Significant achievements and specific challenges. Part 3. Three levels of cervical cancer prevention and treatment. Russian Journal of Biotherapy. 2020;19(3):6–11. doi: 10.17650/1726-9784-2020-19-3-6-11 EDN: ADVGBL
- Clinical recommendations. Cervical intraepithelial neoplasia, erosion and ectropion of the cervix [Internet]. Ministry of Health of the Russian Federation; 2022 [cited 2024 December]. (In Russ.) Available from: https://cr.minzdrav.gov.ru/schema/752_1
- Altová A, Kulhánová I, Brůha L, Lustigová M. Breast and cervical cancer screening attendance among Czech women. Cent Eur J Public Health. 2021;29(2):90–95. doi: 10.21101/cejph.a6623 EDN: WCWABS
- Jolidon V, De Prez V, Willems B, et al. Never and under cervical cancer screening in Switzerland and Belgium: trends and inequalities. BMC Public Health. 2020;20(1):1517. doi: 10.1186/s12889-020-09619-z EDN: PYBVIS
- Pedersen K, Fogelberg S, Thamsborg LH, et al. An overview of cervical cancer epidemiology and prevention in Scandinavia. Acta Obstet Gynecol Scand. 2018;97(7):795–807. doi: 10.1111/aogs.13313 EDN: MCDFKH
- Ojamaa K, Innos K, Baburin A, et al. Trends in cervical cancer incidence and survival in Estonia from 1995 to 2014. BMC Cancer. 2018;18(1):1075. doi: 10.1186/s12885-018-5006-1 EDN: SPMIWZ
- de Rycke Y, Tubach F, Lafourcade A, et al. Cervical cancer screening coverage, management of squamous intraepithelial lesions and related costs in France. PLoS One. 2020;15(2):e0228660. doi: 10.1371/journal.pone.0228660 EDN: XCXSSR
- de Munter AC, Klooster TMST, van Lier A, et al. Determinants of HPV-vaccination uptake and subgroups with a lower uptake in the Netherlands. BMC Public Health. 2021;21(1):1848. doi: 10.1186/s12889-021-11897-0 EDN: WRFKXJ
- Kramer J. Eradicating cervical cancer: Lessons learned from Rwanda and Australia. Int J Gynaecol Obstet. 2021;154(2):270–276. doi: 10.1002/ijgo.13601 EDN: MKNIJF
- Hrgovic Z, Fures R, Jaska S. Implementation of the program for early detection of cervical cancer in the Federal Republic of Germany. Mater Sociomed. 2020;32(1):62–65. doi: 10.5455/msm.2020.32.62-65 EDN: BHHPNC
- Canfell K. Towards the global elimination of cervical cancer. Papillomavirus Res. 2019;8:100170. doi: 10.1016/j.pvr.2019.100170
- Vänskä S, Luostarinen T, Baussano I, et al. Vaccination with moderate coverage eradicates oncogenic human papillomaviruses if a gender-neutral strategy is applied. J Infect Dis. 2020;222(6):948–956. doi: 10.1093/infdis/jiaa099 EDN: GJFLHA
- Patel C, Brotherton JM, Pillsbury A, et al. The impact of 10 years of human papillomavirus (HPV) vaccination in Australia: what additional disease burden will a nonavalent vaccine prevent? Euro Surveill. 2018;23(41):1700737. doi: 10.2807/1560-7917.ES.2018.23.41.1700737
- Dempsey AF. Human papillomavirus: the usefulness of risk factors in determining who should get vaccinated. Rev Obstet Gynecol. 2008;1(3):122–128.
- Luvián-Morales J, Gutiérrez-Enríquez SO, Granados-García V, Torres-Poveda K. Risk factors for the development of cervical cancer: analysis of the evidence. Front Oncol. 2024;14:1378549. doi: 10.3389/fonc.2024.1378549 EDN: DQORET
- Korovkin AS, Nikitina TN, Kozlova TYu, et al. Vaccines against human papillomavirus: organization and experience of preclinical research. Biological Products. Prevention, Diagnosis, Treatment. 2024;24(3):243–254. doi: 10.30895/2221-996X-2024-24-3-243-254
- Mlynarczyk-Bonikowska B, Rudnicka L. HPV infections-classification, pathogenesis, and potential new therapies. Int J Mol Sci. 2024;25(14):7616. doi: 10.3390/ijms25147616 EDN: NSVXDG
- Pratiwi SE, Ysrafil Y, Mardhia M, et al. A novel therapeutic multiepitope vaccine based on oncoprotein E6 and E7 of HPV 16 and 18: An in silico approach. Bioimpacts. 2024;14(5):27846. doi: 10.34172/bi.2024.27846 EDN: AALEWB
- Whitworth HS, Gallagher KE, Howard N, et al. Efficacy and immunogenicity of a single dose of human papillomavirus vaccine compared to no vaccination or standard three and two-dose vaccination regimens: A systematic review of evidence from clinical trials. Vaccine. 2020;38(6):1302–1314. doi: 10.1016/j.vaccine.2019.12.017 EDN: AFPTAH
- Drolet M, Bénard É, Pérez N, et al. Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis. Lancet. 2019;394(10197):497–509. doi: 10.1016/S0140-6736(19)30298-3
- McClymont E, Lee M, Raboud J, et al. The efficacy of the quadrivalent human papillomavirus vaccine in girls and women living with human immunodeficiency virus. Clin Infect Dis. 2019;68(5):788–794. doi: 10.1093/cid/ciy575
- Dalla Valle D, Benoni R, Soriolo N, et al. Safety profile assessment of HPV4 and HPV9 vaccines through the passive surveillance system of the Veneto Region (Italy) between 2008 and 2022: A 15-year retrospective observational study. Vaccine X. 2024;19:100511. doi: 10.1016/j.jvacx.2024.100511 EDN: WGQJOT
- Palmer TJ, Kavanagh K, Cuschieri K, et al. Invasive cervical cancer incidence following bivalent human papillomavirus vaccination: a population-based observational study of age at immunization, dose, and deprivation. J Natl Cancer Inst. 2024;116(6):857–865. doi: 10.1093/jnci/djad263
- Oyedeji O, Maples JM, Gregory S, et al. Pharmacists' perceived barriers to human papillomavirus (HPV) vaccination: a systematic literature review. Vaccines (Basel). 2021;9(11):1360. doi: 10.3390/vaccines9111360 EDN: ETVIIJ
Supplementary files
