Cervical Cancer Natural History, Diagnosis, and Treatment: From Molecular Events to Clinical Management

Cervical cancer is a preventable gynecologic malignancy ranking the fourth most common cancer among women in the world. The association between human papillomavirus (HPV) infection and cervical cancer is proven via the identification of high-risk HPV genotypes in more than 95% of cervical cancer specimens. Persistent high-risk HPV infection is the main risk factor for cervical cancer onset and progression, whereas other factors presumably influence the risk of HPV infection acquisition. While the mechanism associated with HPV-independent cervical cancers is unclear, the pathogenesis of HPV-associated cervical lesions and cancer is well-described. Many host, viral, and environmental factors are involved in the pathogenesis of cervical cancer. For more clarity, the pathogenesis of HPV-related cervical cancer can be presented describing changes on the molecular level, cellular level, and tissue level. As the global incidence of cervical cancer continues to rise, the World Health Organization (WHO) announced and stated the implementation of a cervical cancer elimination plan. According to the WHO initiative, HPV vaccination, cervical cancer screening, and treatment of premalignant cervical lesions have to be reinforced. In the absence of HPV-specific medications, clinical specialists and researchers use various medications to manage HPV infection and related lesions. These are imiquimod, cidofovir, anti‐VEGF antibodies, recombinant human IFN α−2b, photodynamic therapy, etc. Moreover, multiple studies are investigating the clinical efficacy of therapeutic HPV vaccines. Diagnosis of cervical cancer is guided by the cancer staging classifications/systems, and management of cervical cancer is directed by international guidelines.