Volume 29, Issue 166, December 2025

Human papillomavirus (HPV) infection – risk factors, mechanisms of carcinogenesis and modern prevention strategies for cervical cancer - a narrative review

Katarzyna Bielawska^1♦, Wiktoria Julia Auguścik¹, Aleksandra Tlak²

¹Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland
²Medical University of Łódź, 4 Tadeusza Kościuszki Street, 90-419 Łódź, Poland

^♦Corresponding Author
Katarzyna Bielawska, Medical University of Warsaw, 61 Żwirki i Wigury Street, 02-091 Warsaw, Poland

ABSTRACT

Cervical cancer is one of the most common cancers worldwide, despite the availability of preventive and diagnostic methods. Progression to cancerous changes takes a long time. Infection with human papillomavirus (HPV) plays a crucial role, but not the only one. Recent studies increasingly show that multiple viral, immunological, hormonal, and microbiological factors influence the course and progression of the infection. This review aims to summarize current knowledge on the mechanisms of HPV-dependent carcinogenesis, with particular emphasis on the role of vaginal microflora, environmental factors, and modern methods of prevention and diagnosis. This review draws on 17 scientific papers published between 2011 and 2025, found through searches in PubMed, Scopus, and Google Scholar. Disruption of the vaginal microbiome may contribute to the persistence of HPV infection. A decrease in Lactobacillus bacteria and an increase in anaerobic bacteria lead to inflammation and oxidative stress, which may facilitate the integration of viral DNA into the host genome. There is increasing emphasis on new diagnostic methods. Testing for epigenetic methylation markers (e.g., CADM1, MAL) may improve the specificity of molecular tests. HPV vaccination is known to be a preventive measure against CIN2+ lesions and cervical cancer. Restoring normal vaginal microflora through the use of probiotics may be an important element in the prevention and treatment of HPV infections in the future. The most effective way to decrease incidence may be to combine comprehensive vaccination programs with modern, integrated screening strategies.

Keywords: cervical cancer, epigenetic biomarkers, human papillomavirus (HPV), microbiota, prevention

Medical Science, 2025, 29, e223ms3736

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Published: 9 December 2025