Microbiome Influence on Cervical Cancer: Pathways to Understanding and Intervention

Cervical cancer (CC) remains a critical global health concern, ranking as the fourth leading cause of cancer-related mortality among women, with an estimated 604,000 new cases and 342,000 deaths in 2020. The primary etiological factor for CC is infection with high-risk strains of the Human papillomavirus (HPV), which often goes unrecognized due to the immune system's ability to clear the virus. Emerging evidence suggests that the vaginal microbiome (VMB) plays a pivotal role in modulating the immune response, influencing oncogenesis, and impacting HPV clearance. This review discusses the dynamics of the VMB, emphasizing its diversity and how various factors, such as hormonal fluctuations and ethnicity, shape its composition. A balanced VMB, characterized by a predominance of Lactobacillus species, is crucial for maintaining local immune defenses and preventing dysbiosis, which can lead to chronic inflammation and increase the risk of CC. Conversely, dysbiotic conditions with reduced Lactobacillus and increased anaerobic bacteria have been correlated with HPV persistence and disease progression. The potential of probiotics to restore a healthy VMB and enhance immune responses offers a promising avenue for CC prevention and management. Further research into the VMB's role in HPV pathogenesis is essential for developing targeted therapeutic strategies to mitigate CC risk.