The vaginal microbiome and gynaecological cancer: exercise caution when considering causation

Genital infection with high-risk human papillomavirus (HPV) is extremely common in young, sexually active women, but most infections are transient and clear without ever causing disease. Persistent infection causes premalignant cervical intraepithelial neoplasia (CIN), which, if left untreated, can undergo malignant transformation and become invasive cancer. Cervical cancer is thus considered a late, rare consequence of persistent high-risk HPV infection (Crosbie et al. Lancet 2013; 382:889-99). Factors that influence the acquisition of genital HPV and the rate of its natural clearance are therefore important in the pathogenesis of cervical cancer. This article is protected by copyright. All rights reserved.