Cervical Health Overview

Principles

Definition

Cervical health is a multidisciplinary concept and research area focused on understanding, maintaining, and improving the physiological state of the uterine cervix, encompassing the investigation of risk factors, prevention strategies, screening methods, and management of related diseases, notably cervical cancer, for the advancement of women's reproductive and overall well-being.

Ontological type

Screening Strategies

Risk Factors

Prevention and Vaccination

Key developments

Key Figures

Cytology-to-HPV Integration era

F. Xavier Bosch [1] is a key figure associated with the Institute of Cancer Research [3] and Johns Hopkins University [4] during the Cytology-to-HPV Integration era. His contributions include the population-based case-control study that established the causal link between human papillomavirus and invasive cervical cancer in Colombia and Spain [6], and the 1993 work identifying risk factors for cervical intraepithelial neoplasia grade III/carcinoma in situ in Spain and Colombia [7], which were pivotal in anchoring HPV as etiologic and shaping era-appropriate screening and risk models. Carmen Navarro [2] is associated with Johns Hopkins University [4] and Sorbonne Université [5] in this era. Her key contribution centers on the 1992 population-based case-control study demonstrating the HPV-cervical cancer causal link, conducted across Colombia and Spain [6], which helped establish HPV's etiologic role and steered the integration of HPV-based risk assessment in screening.

HPV Screening Consolidation & Vaccination era

Chris J.L.M. Meijer [1], affiliated with Oncode Institute [3] and Johns Hopkins University [4], contributed during the HPV Screening Consolidation & Vaccination era. His work connected HPV status to cervical lesions and consequences for cervical-cancer screening (Relation of human papilloma virus status to cervical lesions and consequences for cervical-cancer screening: a prospective study) [6], examined how oral contraceptives influence cervical cancer risk in HPV-infected women (Effect of oral contraceptives on risk of cervical cancer in women with human papillomavirus infection: the IARC multicentric case-control study) [7], and contributed to guidelines for HPV DNA test requirements for primary cervical cancer screening in women 30 years and older (Guidelines for human papillomavirus DNA test requirements for primary cervical cancer screening in women 30 years and older) [8], thereby informing policy-relevant risk stratification and triage during the consolidation era. Elizabeth R. Unger [2], with positions at Johns Hopkins University [4] and Karolinska Institutet [5], contributed during this era. Her key contribution is the Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP) paper [9], which underpinned vaccination program development in tandem with screening strategies during this era.

HPV-First Screening & Elimination era

Chris J.L.M. Meijer [1], affiliated with Karolinska Institutet [3] and Wageningen University & Research [4], helped shape the HPV-first screening paradigm in this era. Meijer [1] co-authored the 2013 Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials [6], and contributed to the 2013 CADM1andMALpromoter methylation levels in hrHPV-positive cervical scrapes increase proportional to degree and duration of underlying cervical disease [7], which highlighted methylation-based risk stratification for triage. Peter J.F. Snijders [2], affiliated with Karolinska Institutet [3] and Vrije Universiteit Amsterdam [5], has also been central to implementing HPV-based screening paradigms in this era. Snijders [2] co-authored the same HPV-based screening follow-up paper [6] and the CADM1andMALpromoter methylation levels in hrHPV-positive cervical scrapes increase proportional to degree and duration of underlying cervical disease [7], contributing to the evidence base for HPV-primary screening and molecular triage essential for risk-based pathways toward population-level elimination.