Search Results (152)

High mortality rates and poor quality of life result from the late-stage detection and frequent recurrence of gynecological neoplasms. Background/Objectives: The aim of this study was to conduct a systematic analysis of the energy parameters of photodynamic therapy (PDT) in the treatment of cervical and vulvar lesions, with a focus on stimulating immune responses leading to human papillomavirus (HPV) eradication and lesion regression without adverse effects, such as thermal damage. Methods: A total of 46 peer-reviewed studies published between January 2010 and April 2024 were analyzed. These studies focused on PDT applications for cervical and vulvar lesions, sourced from Google Scholar, Scopus, and Web of Science. Results: Although PDT shows promise, significant limitations exist, such as insufficient consideration of individual tumor characteristics, restricted treatment depths, and the heterogeneous distribution and low selectivity of photosensitizer (PS) accumulation in tumors. Tumor hypoxia further reduces PDT’s effectiveness, and most studies overlook immune system activation, which is crucial for targeting HPV infections and improving antitumor responses. Conclusions: Advancing the research into PDT’s molecular and cellular mechanisms, optimizing the immune response stimulation, and improving the PS and delivery methods could enhance the safety and effectiveness of cervical and vulvar neoplasm treatments. The use of personalized PDT parameters may reduce the side effects and enhance the outcomes for patients suffering from gynecological diseases. Full article

Artocarpus heterophyllus (jackfruit) is widely distributed in subtropical and tropical regions, and some phytochemicals isolated from this species have demonstrated anti-proliferative effects. However, its impact on triple-negative breast cancer (TNBC) and HPV-related cervical cancer models remains unclear. This study evaluated the phytochemical profile and anticancer activity of an ethanolic extract from A. heterophyllus leaves (AHEE) in the TNBC cell line MDA-MB-231 and in the HPV-16⁺ murine cancer cell line TC-1. Phytochemical screening and spectroscopic analyses (UV-Vis, IR, ¹H, and ¹³C NMR) revealed the presence of tannins, alkaloids, steroids, coumarins, and flavone-type flavonoids, with a total phenolic content of 3.34 µg GAE/mg and flavonoid content of 0.44 mg QE/g extract. In 2D cultures, AHEE reduced cell viability by 49% in TC-1 and 24% in MDA-MB-231 at 300 µg/mL, inhibited colony formation and migration in TC-1, and impaired survival but not migration in MDA-MB-231. In 3D cultures, 250 µg/mL inhibited proliferation, migration, and anchorage-independent growth in both cell lines. Furthermore, the combination of AHEE with one-fifth of the IC₅₀ of doxorubicin or cisplatin produces an effect comparable to that observed with the full IC₅₀ of these drugs. These findings suggest that AHEE possesses anticancer activity with cell-type-specific effects and highlight its potential as an adjuvant therapy. Further studies are warranted to elucidate its mechanisms of action. Full article

Background/Objectives: Vaginal adenocarcinoma is a rare malignancy, accounting for less than 10% of all primary vaginal cancers. It predominantly affects older women but can also occur in younger populations, particularly in association with in utero diethylstilbestrol (DES) exposure. Given its rarity, evidence regarding the optimal management of vaginal adenocarcinoma remains limited. This review aimed to summarize the current understanding of vaginal adenocarcinoma, covering the epidemiology, etiology, diagnostic approaches, treatment modalities, prognosis, and areas requiring further investigation thereof. Methods: We conducted a search for the term “vaginal adenocarcinoma” in the PubMed, Scopus, and Web of Science databases from January 2016 to 28 April 2025. Results: Overall, 83 articles were included in the final review. Among them, 21 cases of vaginal adenocarcinoma were reported. Vaginal adenocarcinoma demonstrates a bimodal age distribution, with clear cell histology commonly linked to DES exposure and endometrioid or mucinous types seen in older patients. Risk factors include DES exposure, chronic inflammation, and human papillomavirus (HPV) infection. The diagnosis relies on a pelvic examination, imaging, and biopsy. Treatment typically involves surgery, radiotherapy, or a combination thereof, tailored to the stage and location, with chemotherapy reserved for advanced cases. The prognosis depends on the histologic subtype, tumor size, stage, and treatment response, with early-stage disease generally associated with better outcomes. Conclusions: Improved awareness of risk factors and early diagnostic strategies is critical to optimize patient outcomes. Research is needed to refine treatment protocols, explore targeted therapies and immunotherapy, and investigate the molecular underpinnings of vaginal adenocarcinoma, particularly non-DES-associated types. Full article

Background/Objectives: Understanding the regional distribution of human papillomavirus (HPV) genotypes is essential for guiding effective vaccination and screening strategies. This study aimed to assess the prevalence and distribution of HPV genotypes among unvaccinated women aged 30 years and older undergoing routine screening in Ankara. It also aimed to compare the frequencies of genotypes included and not included in current vaccines and to investigate their association with cervical smear cytology. Methods: This descriptive, cross-sectional, single-center study was conducted at Ankara Etlik City Hospital between 15 November 2024 and 15 February 2025. A total of 500 sexually active, unvaccinated women aged 30 years or older were enrolled. Cervical swab samples were analyzed for HPV DNA and genotypes using real-time PCR (28-type panel), and cytology results were retrospectively obtained from medical records. Results: HPV infection was detected in 18.2% of participants. Among HPV-positive women, 71.4% had single-type and 28.6% had multiple-type infections. The most common high-risk genotypes among HPV-positive individuals were HPV 16 (13.2%), HPV 18 (13.2%), and HPV 59 (13.2%). While 35.2% of HPV-positive cases included genotypes covered by the nonavalent vaccine, 64.8% involved at least one genotype not covered, mainly HPV 59, 44, and 51. HPV was detected in 17% of individuals with normal cytology, 19% of those with atypical squamous cells of undetermined significance (ASC-US), and 100% of cases with low-grade squamous intraepithelial lesion (LSIL) (p < 0.001). Conclusions: The findings emphasize the persistence of high-risk and non-vaccine-covered HPV types in the population, highlighting the need for updated vaccination policies and the development of broader-spectrum vaccines aligned with local genotype profiles. Full article

Sex workers and formerly incarcerated people with a cervix face significant structural, interpersonal, and emotional barriers to cervical cancer screening, despite being at elevated risk for HPV infection. HPV self-sampling (HPV-SS) is a validated, user-directed method that has the potential to address these barriers, yet it remains excluded from Ontario’s organized screening program. This qualitative study explored the lived experiences of structurally marginalized individuals with a cervix who were offered HPV-SS as part of a mixed-methods pilot in the Greater Toronto Area. Five virtual focus groups were conducted with 34 participants, including both those who used the HPV-SS kit and those who declined it. Using inductive thematic analysis, we identified barriers to traditional screening including fear, stigma, mistrust of healthcare providers, logistical constraints, and a lack of accessible information. HPV-SS was widely described as more acceptable, empowering, and emotionally manageable, offering participants autonomy, privacy, and control over their care. Concerns included swab design, uncertainty about correct use, and unclear follow-up after positive results. Participants offered concrete, community-informed recommendations to improve HPV-SS implementation, including opt-in distribution models, gender-affirming language, and trauma-informed educational materials. The findings highlight the urgent need to integrate HPV-SS into organized screening programs to advance equitable access to cervical cancer prevention for marginalized populations. Full article

Background: the distribution of human papillomavirus (HPV) infection, vaccination rates, and awareness levels varies across China. Methods: this study examined HPV infection prevalence, vaccine uptake, and barriers among 2440 women aged 30–64 in Shenzhen, China, using partial least squares structural equation modeling (PLS-SEM) to analyze associated factors. Results: The overall HPV prevalence was 14.2% (347/2440), with HPV52 being the most common type, followed by HPV58 and HPV53. Factors significantly associated with HPV infection included more sexual partners, genital tract infections, manual labor, and single marital status (p < 0.05), whereas higher education demonstrated a protective association (p < 0.05). The HPV vaccination rate was 41.8% in ages 30–45. There were direct effect indicators of younger age, fewer pregnancies, and premenopausal status (p < 0.05) on HPV vaccine uptake, whereas inversely associated factors included divorce/widowed, lower household income, irregular menstruation, more deliveries, no contraception, and lack of HPV knowledge. Among 828 unvaccinated individuals, 47.9% of those aged 46–64 were willing if the age restrictions were expanded, with the main barrier being a lack of vaccine knowledge (40.7%). Willingness was significantly associated with younger age and healthcare occupation (p < 0.05), but negatively with eastern Shenzhen residence, lower household income, no HPV disease awareness, abnormal leucorrhea, lack of HPV knowledge, and belief against post-vaccination screening (p < 0.05). Conclusions: Socioeconomic disparities in HPV infection and vaccination rates in Shenzhen highlight intervention priorities. The impact of HPV knowledge underscores the need for effective health communication. The vaccination willingness and infection status among women aged 45+ provide supporting evidence for expanding HPV vaccination to older age groups. Full article

Persistent high-risk human papillomaviruses (HR-HPVs) infection is the leading cause of cervical cancer. With over 200 circulating genotypes, HPV detection, management, and prevention remain challenging. In Benin, HPV prevalence and genotype distribution are largely unknown, and no national HPV vaccination program exists. This study investigates the prevalence, genotypic diversity, and risk factors of HIV–HPV co-infection among women in Cotonou, Benin. Cervical swabs were collected from 100 women living with HIV (WLWHIV) and 51 women without HIV (WWHIV) at two hospitals. DNA extraction and nested polymerase chain reaction (PCR) were used to detect HPV, followed by Sanger sequencing for genotyping. Chi-squared analysis was used to assess risk factors. HPV was detected in 85% (85/100) of WLWHIV and 60.8% (31/51) of WWHIV (p = 0.002), confirming HIV as an independent risk factor. Fifteen HR-HPV genotypes were identified, with HPV 45 most prevalent in WLWHIV and HPV 16 in WWHIV. Notably, HR-HPV 67, 70, and 82 were detected for the first time in Benin. Unmarried status and detectable HIV load were significant risk factors for co-infection. The high HPV prevalence, particularly among WLWHIV, underscores the urgent need for HPV surveillance and vaccination in Benin. Identifying novel HR-HPV genotypes highlights the necessity for ongoing monitoring and targeted prevention strategies. Full article

Cervical cancer causes 350,000 deaths annually, with 90% occurring in low- and middle-income countries (LMICs), despite being largely preventable through vaccination and screening. This review examines innovative approaches to address screening coverage gaps worldwide, analysing both established programmes in high-income countries and implementation strategies for LMICs. Self-sampling technologies demonstrate significant potential to improve the uptake of cervical screening, thereby improving cervical cancer prevention compared to traditional methods, particularly benefiting underserved populations across all healthcare settings. Among self-collection devices, vaginal brushes achieve sensitivity of 94.6% (95% CI: 92.4–96.8) for HPV detection, while novel approaches like the tampon show promising results (sensitivity 82.9–100%, specificity 91.6–96.8%) with high user acceptability. Implementation strategies vary by healthcare context, with high-income countries achieving success through integrated screening programmes and digital solutions, while LMICs demonstrate effective adaptation through community-based distribution (20–35% uptake) and innovative delivery methods. In resource-limited settings, self-sampling increases participation through enhanced patient comfort and cultural acceptability, while reducing costs by 32–48%. Progress toward WHO’s cervical cancer elimination goals require careful consideration of local healthcare infrastructure, cultural contexts and sustainable financing mechanisms. Future research priorities include optimising self-sampling technologies for sustainability and scalability, developing context-specific implementation strategies and validating artificial intelligence applications to enhance screening efficiency across diverse healthcare settings. Full article

Cervical cancer ranks third in mortality and fourth in incidence among women worldwide as one of the leading causes of death from cancer in females. The main reason behind cervical carcinogenesis is long-term infection with high-risk human papillomavirus (HPV) genotypes, particularly HPV16 and HPV18. This review investigates HPV distribution across the world, along with cervical cancer molecular development mechanisms and current treatment strategies. Epidemiological data show that disease patterns vary significantly between different geographic regions because underdeveloped nations bear a higher disease burden. The molecular mechanisms of oncogenes E6 and E7 disrupt tumor suppressor pathways, while epigenetic modifications through DNA methylation and miRNA dysregulation promote malignant cell transformation. The reduction in HPV infection through prophylactic vaccination has shown promise, yet barriers related to accessibility and coverage still exist. The therapeutic technologies of gene expression inhibitors together with immunotherapies and epigenetic targeting agents show promise but require optimization to achieve specific targeting while minimizing off-target effects. A combined approach that integrates HPV vaccination with early diagnosis and molecular-specific therapies represents the most effective method to manage cervical cancer impact. The future care of patients will require increased translational research along with better immunization programs to drive prevention and therapeutic outcomes. Full article

Background/Objectives: Persistent infection with high-risk (HR) HPV genotypes is the main risk factor for the development of cervical cancer. The present analysis provides recent trends on HR-HPV infection rates and the distribution of HR-HPV genotypes among 3500 Greek women between 2021 and 2023. Methods: The detection of HR-HPVs and the specific identification of HPV16 and HPV18 were conducted using the Roche Cobas 4800 HPV assay. The genotyping of 12 other HR-HPV genotypes was performed through the Nested Multiplex PCR methodology (NMPCR). Results: The overall infection rate was 8.8% with the most prevalent HR-HPV genotype being HPV16 followed by HPV31, HPV66, HPV56, HPV51, HPV58, HPV45, HPV18, HPV68, HPV59, HPV52, HPV35, HPV39, and HPV33. Among HR-HPV-positive cases the prevalence of single, double, triple, and quadruple infections was 73.9%, 19.9%, 5.5%, and 0.7%, respectively. Age-specific analysis showed that the HR-HPV infection rate was higher in the age group of 31–35 years (25.5%) and it was estimated that multiple infections occur more often in younger women. Notably, the distribution of HR-HPV genotypes varies among different age groups. It is proposed that HPV16, HPV31, HPV56, and HPV66 may show an increased possibility of establishing long-term infections in Greek women over 36 years old. Conclusions: The high rates of specific HR-HPVs which are not included in the prophylactic vaccines underlines the significance of constant surveillance of circulating HPVs in the Greek population. Full article

The distribution of human papillomavirus (HPV) genotypes shows inconsistencies across countries, ethnicities, and socioeconomic levels. An in-depth identification of HPV infection rates and genotypes across regions, ethnicities, and age groups in large populations is crucial. We aimed to assess the prevalence of HPV infections among Korean women and investigate the prevalence of multi-type infections among HPV types. To identify HPV types, 16,669 specimens were subjected to DNA extraction and real-time polymerase chain reactions. The HPV infection rate was 36.7%, with single- and multi-type HPV infection rates of 21.4% and 15.3%, respectively. The prevalence of HPV infection was higher among women in their 20s and 60s. HPV types 16 and 18 were most commonly multi-type infected with HPV type 52. In conclusion, promoting HPV awareness and prevention strategies and incentivizing vaccination can boost vaccination rates among eligible individuals. Full article

Human-papillomavirus-positive oropharyngeal squamous cell carcinoma (HPV-positive OPSCC) is a distinct disease characterized by unique clinical and molecular features compared to HPV-negative OPSCC. A comprehensive bibliometric analysis of HPV-positive OPSCC research was conducted in this study to identify key trends, research hotspots, and emerging frontiers in the field. Data were retrieved from the Web of Science Core Collection database. The distributions of contributors, including countries, institutions, authors, journals, and cooperative networks related to HPV-positive OPSCC, were analyzed and visualized using VOSviewer 1.6.20, CiteSpace 6.3.R1, and the R package Bibliometrix 4.0.0. In addition, the most influential publications and high-frequency keywords were identified and analyzed to discern key topics in this field. A total of 3895 articles and reviews on HPV-positive OPSCC were identified, involving 106 countries, 620 journals, and 18949 authors. The main contributors include the USA (1908 publications), Johns Hopkins University (310 publications), the journal Head and Neck (320 publications), and Erich M. Sturgis (94 publications). The top three keywords are “survival”, “radiotherapy”, and “p16”. There has been a steadily increasing research interest in HPV-positive OPSCC over the last 23 years. Current studies focus on diagnosis, treatment strategies, prognosis, recurrence, and disease surveillance. This bibliometric analysis highlights key contributors and emerging themes, offering insights for future research directions. Full article

Papillomaviruses are double-stranded DNA viruses, and it is essential to clarify their genotypic distribution for their effective prevention and clinical management. In this study, we aimed to evaluate the prevalence of HPV genotypes in the normal oral mucosae of HIV-positive individuals. A systematic literature search was conducted across PubMed, Web of Science, Scopus, and Google Scholar to identify peer-reviewed studies published up to 13 February 2025. The inclusion criteria referred to original research studies reporting on the prevalence and genotype-specific distribution of HPV in the oral mucosae of HIV-positive individuals. Statistical analyses were conducted using the MedicReS E-PICOS AI smart biostatistics software (version 21.3, New York, NY, USA) and the MedCalc statistical software package (MedCalc Software Ltd., Ostend, Belgium). The pooled prevalence estimates were calculated using a random-effects meta-analysis model, and heterogeneity was quantified using the Cochrane Q and I² statistics. The presence of publication bias was assessed via the Begg and Mazumdar rank correlation test. High prevalence and heterogeneity of HPV-58 (6.23%), HPV-16 (4.326%), and HPV-66 (3.733%) were observed, indicating significant variability across populations and methodologies. This supports their association with HPV-related oropharyngeal malignancies and the need for the continuous surveillance of HIV-positive individuals. We also observed the elevated detection of LR-HPV genotypes, particularly HPV-13 (7.16%), HPV-5 (5.64%), and HPV-62 (4.24%). These findings indicate that there is substantial heterogeneity in the prevalence of both HR-HPV and LR-HPV genotypes among HIV-positive individuals, with certain genotypes exhibiting higher detection rates across studies, emphasizing the need for targeted surveillance and preventive strategies in this vulnerable population. The application of advanced data analysis methods is essential in enhancing HPV surveillance and implementing effective control measures in this vulnerable population. Full article

Background and Objectives: Interest in defining the characteristics of the cervicovaginal microbiota (CVM) in invasive cervical cancer (ICC) is growing, particularly concerning Lactobacillus species, as evidence suggests that these may differ in affected women and potentially interact with Human Papillomavirus (HPV) infection. Understanding these features could have important implications for disease management. Thus, this study aims to systematically review the main characteristics of available literature exploring the relationship between CVM diversity, Lactobacillus profiles, and HPV in ICC; Methods: A comprehensive bibliographic search was conducted across databases, including Medline, Embase, Scopus, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov, in accordance with the to the PRISMA guidelines. The review included studies that met the following inclusion criteria: studies comparing CVM in women with ICC to controls, focusing on Community State Types (CSTs), Lactobacillus profiles, and microbial diversity. Exclusion criteria included commentaries, letters, reviews, and studies without control groups. Variables were analyzed using the Kruskal–Wallis and Fisher’s exact tests, with statistical significance level set at 0.05. Data analysis was conducted and reviewed in a blinded manner. Results: A total of 28 studies published between 2015 and 2024 met the inclusion criteria. A total of 2082 patients were included, with 323 (41.9%) of the 770 cases testing positive for HPV and 327 (24.9%) of the 1312 controls testing positive for HPV. A total of 18 studies specifically examined HPV genotypes. Cervical swabs were employed in 19 out of 28 studies (67.9%), while vaginal swabs were used in 17 studies (60.7%). Additionally, two studies included samples collected via cervical biopsy (7.1%), four studies utilized cervicovaginal lavage (14.3%), and one study used a cervical brush for sample collection (3.6%). Regarding microbiota profiling, 26 studies (92.9%) employed 16S rRNA analysis, while one study (3.6%) utilized whole-genome sequencing (WGS), and another (3.6%) used 16s rDNA. A total of 10 studies (35.7%) examined the distribution of CSTs. Five studies (17.9%) reported on Lactobacillus profiles. Different levels of Lactobacillus crispatus and Lactobacillus iners were observed, along with variations between Lactobacillus-dominant and Lactobacillus-depleted communities. A total of 22 studies (78.6%) assessed α-diversity, and 17 studies (60.7%) examined β-diversity; Conclusions: This study emphasizes the heterogeneous features of the studies exploring the association between alterations in the CVM, HPV, and the development of ICC, suggesting the need for further research to better understand this relationship. These findings could inform new strategies for prevention and treatment. Full article

The aim of this study was to investigate the distribution of human papillomavirus (HPV) genotypes among cervical cancer cases in Moroccan women living in the Souss-Massa region. A total of 155 formalin-fixed, paraffin-embedded cervical tissue samples were tested for the presence of HPV DNA using a semi-nested PCR assay. HPV genotypes were identified using a direct Sanger sequencing assay. The prevalence of HPV was 85.8%. HPV DNA was found in 87.5% of high squamous intraepithelial lesions (HSIL) cases and 85.7% of invasive cervical cancer (ICC) cases. Ten distinct HPV genotypes were identified, including seven high-risk HPV (HR-HPV) genotypes and three low-risk HPV (LR-HPV) genotypes. Among HR-HPV genotypes, HPV16 was the most prevalent in both HSIL and ICC, detected, respectively, in 42.9% and 55.6% of cases. In ICC cases, HPV18 was the second most common genotype detected, in 10.3% of cases. In addition, HPV31, 33, 35, 45 and 58 were detected in 10.4% of ICC cases. LR-HPV genotypes, namely HPV62, 70 and 87, were detected in 2.4% of ICC cases. Adenocarcinoma (ADC) accounted for 4.1% of ICC cases, with HPV 16 and HPV 18 identified in 60% and 40% of these cases, respectively. Overall, our findings show that the genotypes covered by the bivalent and nonavalent HPV vaccines account, respectively, for 65.4% and 74.6%. These results highlight the importance of introducing HPV vaccination and primary HPV testing for mass screening in Morocco in order to effectively prevent and manage cervical cancer and ultimately save women’s lives. Full article