Improving the vaginal microbiota to combat human papillomavirus infection and cervical cancer in climacteric women

Human Papillomavirus (HPV) and cervical cancer

• The human papillomavirus (HPV) is one of the most common sexually transmitted infections.
• Approximately 75% of sexually active women will become infected during their lives. Normally, these infections resolve within 2 years in immunocompetent women, but some HPV infections can progress to cervical cancer and reinfection with the same or a different HPV can also occur.
• Chronic oncogenic HPV infection is a necessary cause and the main risk factor for the development of cervical cancers, as well as other anogenital and oropharyngeal cancers.
• Cervical cancer was the 4th most common type in women worldwide in 2020 with 604,127 new cases and 341,831 deaths. This is a substantial increase compared to the latest available data, with an increase in incidence and mortality of 5.7% and 8.9%, respectively.

HPV in climacteric women

• In regions all over the world, the prevalence of HPVs is higher in women under 35 years of age and lower in older women.
• However, a second peak of high HPV prevalence (around 10%) is observed during the climacteric life stage in Europe, Africa and Asia.
• The main problem is that an increase in HPV prevalence and a decrease in health care for climacteric women with sexually transmitted diseases converge.

Previous studies

• Studies of HPV prevalence in climacteric women at risk of poverty and/or social exclusion are very scarce, so after an exhaustive search, we have found three studies in North America focusing on this type of population, with a prevalence between 7.2% and 42.5%.
• In these studies, when comparing their prevalence with those of other social classes, the authors conclude that the prevalence of HPV is higher in vulnerable climacteric women, which in turn leads to a higher risk of cervical cancer.
• It should be noted that no recent studies have been found on this problem in other parts of the world that focus on climacteric women at risk of poverty and/or social exclusion.

• With regard to the study of determinants associated with climacteric HPV infection, four studies have been conducted in Asia, the USA and South America. Out of these, only two focus on vulnerable populations (one of the Asian studies and the studies carried out in the USA).
• There are no published studies of these characteristics (neither in the general population nor at risk of poverty and/or social exclusion) in Spain.

• In terms of studies on vaginal microbiota in relation to HPV infection, there are very few studies worldwide on this topic that take into account climacteric women.
• To date, there are no studies on vaginal microbiota and HPV in climacteric women at risk of poverty and/or social exclusion.

Objectives of the project

The general objective of the proposal is to investigate on how to prevent cervical cancers by studying the possible determinants associated with HPV infection and/or chronification climacteric women, with a special focus in vaginal microbiome.

The specific objectives are: