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.

Objective: At the present time, cervical cancer remains the fourth most prevalent cancer among women worldwide. Most cervical cancer cases are attributed to high-risk human papillomavirus (HPV) infection. Because the natural history of cervical cancer takes decades, the disease could be prevented if premalignant conditions are identified and appropriately managed. The aim of this study is to identify the prevalence of precancerous lesions among non-vaccinated women attending the national tertiary care hospital in Kazakhstan. Methods: This was a retrospective study of the cervical cancer screening database (2018) from the national tertiary care hospital in Kazakhstan. Records of 6682 patients, who had cervical cytology tests by Papanicolaou (Pap test), were analyzed. Out of the revised cases, 249 patients had abnormal cervical cytology reports. The Pap test was performed using liquid-based cytology (LBC). The data were analyzed using the statistical software STATA 16. A p-value of less than 0.05 was considered statistically significant. Results: In this retrospective analysis of 6682 patients’ records, we found 3.73% (249 patients) out of all Pap tests performed in 2018 were abnormal. The prevalence of high-grade squamous intraepithelial lesion (HSIL) was high at 19.28%, and the proportion of atypical squamous cells of undetermined significance (ASCUS) and atypical squamous cells (ASCs-H) was 18.47%, while low-grade squamous intraepithelial lesion (LSIL) were identified in 62.25% of the cases. Almost 25% of the women included in the study had concurrent lower and upper genital tract infections. Conclusion: Although the overall rate of abnormal Pap test results was not high, the study shows the elevated prevalence of HSIL. It calls the attention of local policymakers and gynecology specialists and requires immediate actions to improve the prophylactic measures to decrease morbidity and mortality from cervical cancer in Kazakhstan.

Актуальность: В настоящее время рак шейки матки является актуальной проблемой, особенно в Казахстане. Более того, РШМ «молодеет», поражая женщин фертильного возраста, что придаёт особую значимость анализу данных по сохранению фертильности и течению и исходам беременности после лечения РШМ. Несмотря на доказанную взаимосвязь между вирусом папилломы человека и возникновением рака шейки матки (РШМ) и применяемые меры профилактики и скрининга, в Казахстане среди женщин в возрасте до 45 лет РШМ является 2-м самым распространенным злокачественным заболеванием. РШМ, выявленный в репродуктивном возрасте, и последующая необходимость проведения органоуносящих операций, приводит в инвалидизации молодых женщин, лишая их возможности иметь потомство. Цель исследования – расширение представлений о течении и исходах беременности после малоинвазивных методов лечения рака шейки матки на основании обзора современной литературы. Материалы и методы: Проведен поиск литературы по теме женского бесплодия, сохранения фертильности и РШМ в базах данных Scopus, PubMed, Google Scholar и Embase с 2014 года до середины 2024 года. Результаты: Ранняя диагностика РШМ дает возможность проведения органосохраняющих операций и сохранения фертильности возрастает. Имеющиеся в литературе наблюдения о репродуктивных исходах основаны на результатах, полученных у пациенток с ранними стадиями РШМ (IB1). Заключение: Ограниченные данные по течению и исходам беременности доступны в исследованиях пациенток с IB2 и IIA1 стадиями РШМ. Проведение дальнейших исследований в данной области и освещение результатов лечения по сохранению репродуктивной функции при РШМ в стадии IB2 и IIA1 позволят улучшить исходы для больных.

Introduction: Human papillomavirus (HPV) is the main cause of cervical cancer. Cervical-vaginal infection with pathogens such as bacterial vaginosis, mycoplasmosis, and vaginal candidiasis may be a cofactor. This study aimed to assess the impact of co-infection with human papillomavirus and sexually transmitted infections on the development of cervical precancerous conditions in reproductive-age women. Materials and Methods: In the study, 402 women had smears taken for cytological examination and cervical scrapings taken for sexually transmitted infections (STIs). The samples were analyzed by polymerase chain reaction. Results: In the study, the incidence of STIs was 77.8%, with rates being two times lower in the HPV-positive group (33.9% versus 66.1% among HPV-negative women, p = 0.4). Notably, all women with mild and severe dysplasia had a combination of HPV and STIs. A typical combination was HPV 16, 58, and 33, often accompanied by Gardnerella vaginalis, cytomegalovirus, or Candida albicans. Conclusion: Women positive for HPV and STIs had abnormal Pap smears. Women with cervical precancerous lesions and vaginal infection were less likely to have HPV, except in high-grade squamous intraepithelial lesions. Women with high grade squamous intraepithelial lesions HPV were combined with Gardnerella, mycoplasmosis, and candidiasis.