In 2020, approximately 604 127 patients were newly diagnosed with cervical cancer and 341 831 died of the disease worldwide. Unfortunately, 85–90% of new cases and deaths occur in less developed countries. It is well known that persistent human papillomavirus (HPV) infection is the main risk factor for developing the disease. There are more than 200 HPV genotypes identified, but the most important in public health are the high-risk HPV genotypes including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59 due to their strong association with cervical cancer. Among these, genotypes 16 and 18 are responsible for about 70% of cervical cancer cases worldwide. Implementing systematic cytology-based screening, HPV screening, and HPV vaccination programs have successfully decreased the cervical cancer burden, particularly in developed countries. Although the etiological agent has been identified, we have seen the impact of well-conducted screening programs in developed countries, and we have available vaccines, the fight against this preventable disease has shown poor results globally. In November 2020 the World Health Organization launched its strategy to eliminate cervical cancer from the earth by 2130 (the goal is to achieve a global incidence lower than 4 per 100 000 women/year). The strategy aims to vaccinate 90% of girls before 15 years of age, to screen with a highly sensitive test (HPV-based) 70% of women at 35 and 45 years of age, and to provide proper treatment by trained personnel to 90% of women diagnosed with either cervical dysplasia or invasive cervical cancer. The objective of this review is to update the state of the art on primary and secondary prevention of cervical cancer.

Cervical cancer is the fourth most frequent cancer in women worldwide, representing nearly 8% of all female cancer deaths every year. The majority of cases of cervical cancer are caused by human papillomavirus (HPV); however, up to 5% of tumors are not associated with HPV-persistent infection and, moreover, the new WHO Female Genital Tumors classification subdivided cervical squamous and adenocarcinomas into HPV-associated and HPV-independent tumors. Based on this new information, the aim of this review is to provide an overview of HPV-independent cervical cancer, evaluating diagnostic techniques, molecular profiles, and clinical outcomes. The HPV-independent tumors are characterized by a differentiated molecular profile with lower proliferative activity, a p53 immunostaining, a decreased expression of cyclin-dependent kinase inhibitor proteins, such as p16, p14, and p27, and alterations in PTEN, p53, KRAS, CTNNB1, ARID1A, and ARID5B. HPV-independent tumors are associated with both adenocarcinomas and squamous histologic subtypes, with lymph node involvement in the early stages, more distant metastasis, and generally worse oncological outcomes. Thus far, no specific therapeutic strategies have been developed based on HPV status; however, with advancing knowledge of differences in the molecular profiles and possible targetable alterations, novel approaches may offer potential options in the near future. Investigators should report on clinical outcomes, evaluating the overall response rates to specific treatments, and consider new biomarkers to establish more accurate prognostics factors.

Cervical cancer is a major global health issue, ranking as the fourth most common cancer in women worldwide. Depending on stage, histology, and patient factors, the standard management of cervical cancer is a combination of treatment approaches, including (fertility- or non-fertility-sparing) surgery, radiotherapy, platinum-based chemotherapy, and novel systemic therapies such as bevacizumab, immune checkpoint inhibitors, and antibody-drug conjugates. While ambitious global initiatives seek to eliminate cervical cancer as a public health problem, the management of cervical cancer continues to evolve with major advances in imaging modalities, surgical approaches, identification of histopathological risk factors, radiotherapy techniques, and biomarker-driven personalized therapies. In particular, the introduction of immune checkpoint inhibitors has dramatically altered the treatment of cervical cancer, leading to significant survival benefits in both locally advanced and metastatic/recurrent settings. As the landscape of cervical cancer therapies continues to evolve, the aim of the present review is to provide a comprehensive discussion of the current state and the latest practice-changing updates in cervical cancer.

Ecancermedicalscience is the peer-reviewed open access cancer journal founded by the European Institute of Oncology in Milan. We consider articles on all aspects of research relating to cancer, including molecular biology, genetics, pathophysiology, epide

Ecancermedicalscience is the peer-reviewed open access cancer journal founded by the European Institute of Oncology in Milan. We consider articles on all aspects of research relating to cancer, including molecular biology, genetics, pathophysiology, epide