Latest updates on cervical cancer in 2025: A comprehensive review of pathogenesis, prevention, and therapeutic advances

Cervical cancer has continued to pose a substantial global health burden, ranking as the fourth most prevalent malignancy among women worldwide. Although preventable through human papillomavirus (HPV) vaccination and early detection strategies, over 342,000 deaths were attributed to the disease in 2020, with more than 90% occurring in low- and middle-income countries (LMICs). The oncogenesis has been primarily driven by high-risk HPV types—particularly HPV16 and HPV18—via the actions of E6 and E7 oncoproteins, which inactivate key tumor suppressors, p53 and pRB, leading to malignant transformation. In this review, recent advancements in cervical cancer prevention, screening, and treatment have been systematically evaluated to support global elimination efforts. A literature search covering the years 2018 to 2023 was performed using PubMed, Embase, and Cochrane databases. The findings highlighted that while liquid-based cytology and HPV DNA testing remain the current gold standard for screening, novel biomarkers such as DNA methylation markers (e.g., FAM19A4/miR124-2) and dual-staining techniques (e.g., p16/Ki-67) have demonstrated improved sensitivity in detecting precancerous lesions. Prophylactic HPV vaccines, including Gardasil-9 and Cervarix, were shown to be over 90% effective in preventing HPV-associated neoplasia. However, coverage remained disproportionately low in LMICs, with vaccination rates under 15% in regions such as Africa. Therapeutically, immune checkpoint inhibitors like pembrolizumab and cemiplimab yielded objective response rates ranging from 14% to 26% in advanced or recurrent disease, while combination regimens are under active investigation. Despite these advances, significant barriers persisted in LMICs, including limited healthcare infrastructure, suboptimal screening uptake, and frequent late-stage diagnoses. The introduction of point-of-care HPV testing platforms, such as careHPV, and the WHO's endorsement of a single-dose vaccination regimen in 2022 have been recognized as potentially transformative strategies for expanding access. It has been concluded that a coordinated, multipronged approach is essential to achieve cervical cancer elimination. Priorities must include universal HPV vaccination, tiered screening strategies enhanced by AI technologies, and equitable access to advanced therapeutics. Through strengthened global partnerships and policy integration, the goal of eliminating cervical cancer by 2030 may be realistically attained.