Cervical cancer remains a significant global health concern, ranking as the fourth most common cancer in women worldwide, with an estimated 660,000 new cases and 350,000 deaths in 2022. The burden is unevenly distributed, with over 85% of cases occurring in low- and middle-income countries, where access to preventive care and treatment is limited. In contrast, the incidence and mortality rates in the United States have declined substantially due to widespread implementation of cervical cancer screening programs and human papillomavirus (HPV) vaccination, with an estimated 13,820 new cases and 4,360 deaths expected in the US in 2024. 

Cervical cancer develops from a multistep transformation process triggered by persistent infection with high-risk types of HPV, most notably HPV 16 and 18. These oncogenic strains integrate into host DNA, expressing viral proteins E6 and E7, which inactivate the tumor suppressors p53 and retinoblastoma protein (Rb), respectively, and promote genomic instability. The progression from infection to cervical intraepithelial neoplasia and eventually invasive carcinoma may take 15-20 years after initial HPV infection, providing a window for early detection and prevention.

Histologically, the majority of cervical cancers are squamous cell carcinomas (~80%), followed by adenocarcinomas and adenosquamous carcinomas. The World Health Organizationnow distinguishes between HPV-associated and HPV-independent tumors, with the latter comprising roughly