Abstract
Chlamydia trachomatis (CT) is an obligate intracellular, Gram-negative bacterium that causes a variety of infections in both humans and animals. It is the causative agent of one of the most common sexually transmitted infections (STIs) with sequelae such as pelvic inflammatory disease, ectopic pregnancy, and infertility. Furthermore, Chlamydia infections have been epidemiologically linked to cervical cancer (CC) in patients with human papillomavirus (HPV) coinfection. However, a molecular mechanism linking Chlamydia to CC is yet to be established, and we still do not know if more aggressive diagnosis and treatment of Chlamydia could possibly lead to lower incidences of CC and associated mortality. Since CC is a leading cause of death among women worldwide, and HPV infection alone is insufficient to cause cancer, our goal was to determine the link between Chlamydia, HPV, and CC. This literature review aimed to understand the pathologic model of CC and how Chlamydia might induce or promote carcinogenesis alone or alongside HPV. In addition, we compared multiple studies attempting to associate Chlamydial infection with CC in different populations and aimed to determine whether there is an epidemiological correlation or not.
Highlights
BackgroundCervical cancer (CC) is the fourth most common cancer among women worldwide, with 604,127 new cases documented in 2020
Many studies have been conducted in order to investigate other risk factors that could be involved in the pathogenesis of CC, either by enhancing susceptibility or facilitating the persistence of human papillomavirus (HPV) infection [6]
A small number of exposed women will have a persistent infection that will eventually progress to cancer
Summary
Cervical cancer (CC) is the fourth most common cancer among women worldwide, with 604,127 new cases documented in 2020. It is the fourth leading cause of cancer-related death in the female population after breast, lung, and colorectal cancers, with 341,834 deaths reported [1]. HPV is a non-enveloped double-stranded DNA virus that can be classified into cutaneous or mucosal and can be either high-risk (hrHPV) or low-risk (lrHPV). Many studies have been conducted in order to investigate other risk factors that could be involved in the pathogenesis of CC, either by enhancing susceptibility or facilitating the persistence of HPV infection [6]. The additional discovered risk factors include HIV, immunosuppression, multiple sexual partners, age of first coitus, cigarette smoking, multiparity, oral contraceptives, low socioeconomic status, nutritional deficiencies, and the presence of other sexually transmitted infections (STI) such as Chlamydia trachomatis (CT) [3,5,7]
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