Background: Although recommended for all member states of World Health Organization, there is no national human papillomavirus vaccination program in Kazakhstan. Furthermore, there are no studies in Kazakhstan that evaluate the mothers’ perception of human papillomavirus vaccines. Objectives: This study aims to assess the knowledge and attitudes toward human papillomavirus vaccination among mothers in Kazakhstan and the factors associated with their attitudes. Design: A cross-sectional study was performed during the period of December 2021—February 2022. The STROBE guideline for cross-sectional studies was applied. Methods: Paper-based structured questionnaires were filled out by 191 mothers, 141 of whom had daughters. The attitude score was assessed as per the Likert-type scale. The Chi-square and Fisher’s exact tests, with a significance value of < 0.05 were used to analyze the relationships between the characteristics of mothers and their attitude scores. Results: The following factors were significantly associated with mothers’ attitudes toward human papillomavirus vaccination: a place of residence, family income, number of children, and refusal of vaccination for themselves (p < 0.005). Of all participants, only 45% of all mothers, 41% of mothers with a female, and 46% of mothers with male children had positive attitudes toward human papillomavirus vaccination. The child’s gender was not a significant determinant. Overall, the level of knowledge about human papillomavirus vaccination was found to be low. The median total score is 0 out of 12 for women who have negative and neutral attitudes toward human papillomavirus vaccines. Among women who have positive attitudes toward HPV vaccines, the median score is around 3 points. Conclusion: Before the implementation of the human papillomavirus vaccination program into the Kazakhstani national vaccination calendar, comprehensive and adequate information and education campaigns are required on the national level for parents and the population in general.

Human papillomavirus (HPV) is a well-established etiological factor in the development of precancerous cervical lesions and cervical cancer. This narrative review synthesizes current evidence on the global prevalence, genotype distribution, and pathophysiological mechanisms of HPV infection, emphasizing regional epidemiological variations that influence prevention and treatment strategies. Particular attention is given to high-risk HPV genotypes, their role in carcinogenesis, and the impact of co-infections and the cervicovaginal microbiota on infection persistence and disease progression. Advances in diagnostic methodologies, including E6/E7 oncoprotein detection, DNA methylation, and microRNA-based assays, are examined in the context of improving screening accuracy and early detection. Furthermore, the review explores the psychological implications of HPV diagnosis and underscores the importance of integrating psychosocial support into clinical management. Given the challenges associated with screening coverage, the potential of self-sampling techniques, particularly in resource-limited settings, is discussed as a means to enhance accessibility and participation in cervical cancer prevention programs. By providing a comprehensive overview of these interrelated factors, this review highlights the necessity of a multidisciplinary approach that integrates novel diagnostic strategies, targeted prevention efforts, and supportive care to mitigate the burden of HPV-associated diseases.

Introduction: Vaginal microbiota has emerged as an important factor influencing human papillomavirus (HPV) persistence and host immunity. While HPV infection is often transient, persistent infections with high-risk HPV genotypes significantly increase the risk of cervical carcinogenesis. Thus, this study aims to investigate the association between microflora/sexually transmitted infections (STIs) and HPV infection, with a focus on the prevalence of coinfection and the potential role of genital tract microecological disorders. Methods: A prospective cohort study was conducted at a tertiary care center in Astana, Kazakhstan, between November 2024 and March 2025. A total of 396 non-pregnant women aged 18–45 years were enrolled during routine gynecological screening. Cervical samples were collected for high-risk HPV genotyping and the detection of 11 other vaginal microorganisms using real-time PCR. Results: HPV-positive women were significantly younger and more likely to be single compared to HPV-negative participants. They also had fewer pregnancies and deliveries and were more likely to use barrier contraception. Among STIs, Mycoplasma hominis demonstrated a significant association with HPV infection (adjusted OR = 2.16, 95% CI: 1.15–4.05, p = 0.017). Overall STI presence (adjusted OR = 2.16, p = 0.017) and STI multiplicity (adjusted OR = 1.36 per additional STI, p = 0.017) were also significantly associated with HPV positivity. Correlation analysis revealed a moderate association between Chlamydia trachomatis and Trichomonas vaginalis (ϕ = 0.39, p < 0.001), suggesting shared ecological or transmission pathways. Conclusion: The findings highlight the relevance of specific vaginal pathogens, particularly Mycoplasma hominis, and co-infection patterns in increasing the risk of HPV infection. These results underscore the importance of comprehensive STI screening and microbial profiling in cervical cancer prevention strategies, especially in populations with limited access to HPV vaccination. Further longitudinal and mechanistic studies are warranted to elucidate causal pathways and progression to cervical neoplasia.

Ntroduction. This studyaimed to assess the level of knowledge, the attitude, and practices of physicians from Kazakhstan on topics related to cervical cancer and Human Papillomavirus (HPV), and to find their associations with socio-demographic variables.Methods. A 41-item questionnaire was distributed online through the snowballing method, which was completed by 389 participants. Any physician who practiced or is practicing in Kazakhstan was eligible for participation. The Poisson test with robust error variances was used for statistical model building. Results. Approximately half of the physicians had appropriate knowledge (score > 70%) on topics of cervical cancer and HPV. Seventy-one percent of physicians expressed intention to vaccinate their own children against HPV. Lessthan half (44.41%) have recommended the HPV vaccine to their patients previously. Younger physicians, pediatricians, and general practitioners had a lower prevalence of appropriate knowledge, a supportive attitude towards the HPV vaccine, and actively recommended the HPV vaccine.Conclusion. Knowledge of physicians regarding cervical cancer and HPV could be improved. Improvement in the attitudes and practices of physicians could positively influence the uptake of cervical cancer screening and HPV vaccine in Kazakhstan.Key words:human papillomavirus, vaccination, cervical cancer, knowledge, physician, Kazakhstan.

Background. Precancerous lesions of the cervix in women of reproductive age are an urgent problem of modern medicine. Despite progress in understanding the molecular mechanisms of human papillomavirus mediated carcinogenesis and the introduction of screening and vaccination programs, the incidence of cervical cancer remains high worldwide. The aim of this study is to identify the prevalence and distribution of the high-risk HPV genotypes among Kazakhstani women and find its correlation with different cervical precancerous lesions. Materials and method. This is a cross-sectional study based on the University Medical Center “National Scientific Center for Maternity and Childhood”. This study included 403 women of reproductive age (18-45 years). Two statistical analyses were used to compare differences between groups: the Kruskal–Wallis test and the Jonckheere– Terpstra test. Results. Age of the patients, Body Mass Index, age at menarche and other variables are distributed similarly among different precancerous lesion groups, suggesting homogeneous distribution of study population among cervical cytological groups. Overall, 35.1% of patients were tested positive for high-risk human papillomavirus in our cohort. Among 12 high risk human papillomavirus genotypes, HPV-16 was the most prevalent high-risk human papillomavirus genotype with prevalence of 11.4%, followed by HPV52 with a prevalence of 6.6% each other and HPV-33 that was present in 5.3% patients who tested positive for human papillomavirus. Conclusion. The result of the current study is consistent with previous findings among other Asian countries and underscores the value of ongoing regional surveillance to inform effective vaccination and screening policy.

Introduction. Cervical cancer is still one of the pressing problems in medicine and public health in Kazakhstan. Infection with high-risk human papillomavirus (HPV) is a key cause of precancerous changes development, which suggests the need to find new ways of diagnosing and assessing risk factors. Aim. To develop an integrated algorithm for evaluation and diagnosis of the risk of precancerous cervical changes caused by HPV, considering the features of modern diagnostic methods and the healthcare system of Kazakhstan. Methods. According to the WHO recommendations and up-to-date literature, an algorithm has been developed for women aged 18 to 70 years. The algorithm includes initial screening for high-risk HPV infection and cytology, and then stratification of patients based on test results. In cases of abnormal cytology and/or high-risk HPV infection, the algorithm includes colposcopy, targeted biopsy, and histopathological confirmation of the results. In addition, vaginal microflora and sexually transmitted infections are assessed, especially in patients who test positive for human papillomavirus. Results. The described algorithm makes it possible to divide patients into groups with low, medium, and high risk, taking into account the presence of HPV, HPV type, cytological and colposcopic manifestations, as well as the presence of STIs and dysbiosis. High-risk status is determined by the detection of HPV-16, cytological changes, and an abnormal colposcopic pattern. Histopathological examination is used to determine the next steps in the treatment of CIN I-III and in situ cancer. Conclusion. The proposed algorithm combines HPV diagnostics, cytology, colposcopy, histology and microbiological studies. This approach may yield better results in terms of early detection of precancerous changes and optimization of patient referrals. It can also be used to prevent cervical cancer. Further study is required to evaluate the diagnostic performance of the algorithm. Keywords: cervical cancer, diagnostics, HPV, algorithm, cytology.