HPV and cervical cancer:  From molecular diagnostics to emerging treatment approaches (Review)

Cervical cancer remains a significant global health challenge, being the fourth most common type of cancer among women and disproportionately affecting those in low‑ and middle‑income countries. Persistent infection with high‑risk human papillomavirus (HR‑HPV), particularly types 16 and 18, is a critical etiological factor in the pathogenesis of cervical cancer. The present review comprehensively explores the molecular biology of HR‑HPV, its role in cervical carcinogenesis, and the anatomical and histological predispositions of the transformation zone. HPV is associated with warts, cervical cancer and other pre‑cancerous lesions. The association between HPV and the development of cervical cancer follows a pattern: Sexual exposure, persistent infection, the development of pre‑cancerous lesions, and progression to invasive disease. Advances in understanding the interplay of genetic polymorphisms, immune evasion strategies and epigenetic modifications, including DNA methylation and histone modifications, have led to the development of novel strategies for diagnostics and therapeutic interventions. While prophylactic HPV vaccination holds promise in mitigating the disease burden, barriers to accessibility, particularly in low‑resource settings, hinder widespread adoption. Vaccination is targeted towards preventing infection; however, the goal of public health is preventing cervical cancer. The present review underscores the need for integrating genomic, immunological and epidemiological perspectives to develop equitable prevention and treatment strategies. The present review advocates for the inclusion of HPV vaccines in national immunization programs and highlights emerging epigenetic biomarkers as potential tools for early detection. In addition to the available prophylactic vaccines, there is a need for the development of therapeutic vaccines that will target cancer cells.