May brought a broad and geographically diverse sweep of cervical cancer research spanning immunotherapy targets, HPV vaccination challenges, innovations in cervical screening, and a recurring focus on the persistent gap between where this disease is preventable and where it continues to cause the greatest harm. The most striking science this month came not from clinical trials, which were largely published in subscription journals and are listed in the licensing-excluded section, but from a dense cluster of open-access research on the real-world obstacles to prevention: vaccine hesitancy in Morocco, cascade-of-care failures in rural China, and the lived experience of women navigating cervical cancer care in Indonesia. A standout immunotherapy study from Antwerp identified CD155 as a promising new treatment target that may be especially relevant for tumors that don't respond to existing checkpoint inhibitors. *The papers highlighted here represent a selection of those published during the month. The papers were selected and summarized by AI. Accuracy of the summaries was confirmed by a scientist.* This digest incorporates only open-access research articles that are free to be read by the entire community and that are explicitly licensed to be shared and reused. --- **A new immunotherapy target emerges beyond PD-L1** The current standard immune checkpoint inhibitor for cervical cancer blocks PD-1 or its partner protein PD-L1 (a brake on immune cells) to help the immune system attack the tumor. But only a fraction of people benefit, and researchers are urgently searching for additional targets. - Researchers at the University of Antwerp used spatial proteomic analysis (a method that maps protein expression in precise physical locations within a tumor) to examine 65 surgically removed cervical cancers across nine different immune checkpoint molecules. Among all markers tested, CD155 stood out: it was the only one consistently linked to poor survival across both tumor regions and an external validation dataset, and it was enriched in the tumor's epithelial layer even in tumors otherwise lacking immune infiltration (so-called "immune-desert" tumors where other checkpoints aren't accessible). CD155 acts through a pathway called the TIGIT axis, which is separate from PD-L1. The finding positions CD155, and drugs targeting the TIGIT axis, as a compelling next candidate for cervical cancer immunotherapy, including for the patients least likely to benefit from pembrolizumab. ([Read the full paper](https://doi.org/10.1136/jitc-2026-014834)) **An unusual cervical tumor subtype responds to a novel combination strategy** Rare, highly aggressive subtypes of cervical cancer present treatment challenges that standard approaches don't address well. - A case report described a patient with a SMARCA4-deficient undifferentiated cervical tumor, a rare and extremely aggressive subtype, who had a primary lesion measuring nearly 10 centimeters. The team treated her with a regimen called PRaG5.0: short-course stereotactic body radiotherapy (SBRT, a precision high-dose radiation approach), combined with cadonilimab, a bispecific antibody that blocks two immune checkpoints simultaneously (PD-1 and CTLA-4), plus the immune-stimulating agents GM-CSF and thymosin α1, followed by chemotherapy with nab-paclitaxel. After initial treatment the tumor shrank substantially, and after consolidation chemotherapy-immunotherapy, the patient's progression-free survival exceeded 12 months. While this is a single case report and the findings cannot be generalized, it illustrates a potential path forward for SMARCA4-deficient tumors that respond poorly to conventional care. ([Read the full paper](https://doi.org/10.3389/fimmu.2026.1826847)) --- **HPV vaccination coverage is the central challenge, and Morocco shows why** Three papers published in May from Morocco offer a granular look at what's really driving low vaccination uptake, and their findings have implications well beyond North Africa. - A national cross-sectional survey of 1,836 girls aged 11-14 in Moroccan middle schools found a vaccination hesitancy rate of 88.8%. The strongest predictor was whether a girl's peers were also unvaccinated; girls whose peers had not been vaccinated were nearly 12 times more likely to be hesitant themselves. Paternal illiteracy, low recommendation from healthcare workers, and the belief that the vaccine promotes sexual activity were also significant risk factors. ([Read the full paper](https://doi.org/10.1371/journal.pone.0347783)) - A companion multicenter survey of 1,444 parents of girls aged 11-14 found that 28.7% refused HPV vaccination for their daughters. Refusal was associated with lower trust in the healthcare system, poor knowledge about cervical cancer and its HPV link, and lack of professional recommendation. Notably, parents who were more educated were actually more likely to refuse, a finding that points to misinformation circulating within educated communities rather than simple knowledge gaps. ([Read the full paper](https://doi.org/10.1371/journal.pone.0348586)) - A mixed-methods study in northern Morocco found that while 60% of parents reported good general acceptability of HPV vaccination, only 8.7% were aware that Morocco even has a national HPV vaccination program that launched in 2022. Qualitative interviews revealed that the primary driver of low uptake was not distrust of the vaccine but simply insufficient awareness that it exists and is available. ([Read the full paper](https://doi.org/10.1186/s12885-026-16111-1)) Together, these three papers describe a system where a national vaccination program is being undermined by social transmission of hesitancy, inadequate healthcare provider engagement, and near-complete invisibility of the program itself. These are fixable problems, but they require active, sustained, and community-appropriate intervention rather than availability alone. --- **Women's experience of screening and care reveals where systems fail** This month's qualitative research offers direct insight into the emotional and logistical realities that shape whether women get screened, stay in care, and receive the support they need. - A qualitative content analysis from Sweden explored why women did or didn't take up HPV self-sampling, a test women collect themselves at home rather than having a clinician perform. Writing narratives submitted by 173 women captured seven distinct themes: from the relief of avoiding a clinical examination, to anxiety about what a positive HPV result might mean, to uncertainty about their own ability to collect a sample correctly. The overarching finding was that self-sampling reduced practical and emotional barriers to participating in screening, but that healthcare providers need to offer personalized support to address the anxiety that can follow a positive result. ([Read the full paper](https://doi.org/10.1186/s12905-026-04517-9)) - Focus group discussions with women, community health workers, and local representatives in Uganda's Mukono and Wakiso districts revealed that barriers to cervical cancer screening operate at every level of the health system simultaneously. Women cited fear of what a positive screening result might mean, concerns about the cost of any follow-up treatment, and the social stigma of being perceived as "adulterous" for seeking cervical screening. Health workers' own negative attitudes, long distances to clinics, and limited availability of follow-up treatment were additional barriers. Importantly, the study also documented strong facilitators, including community sensitization, shared experience between women, and decentralized services, pointing toward what better-designed programs could achieve. ([Read the full paper](https://doi.org/10.1186/s12913-026-14624-w)) - An Indonesian qualitative study interviewed 18 women diagnosed with cervical cancer at a national tertiary referral center in West Java about their experiences from first symptom to start of treatment. Three consistent themes emerged: fragmented referral processes that left women confused about where to go and what to expect; inadequate communication, particularly about what their diagnosis meant, what the treatment side effects would be, and what to do next; and persistent indirect financial burdens despite national health insurance covering the core treatment costs. Women frequently turned to digital search tools to fill information gaps that their healthcare providers had left empty. The study identifies a critical gap between Indonesia's policy goals for cervical cancer elimination and the reality women encounter when they enter the system. ([Read the full paper](https://doi.org/10.1186/s12905-026-04493-0)) --- **Self-sampling for cervical screening: which device do women prefer?** The shift toward HPV self-sampling as a primary screening tool, particularly for reaching women who have never been screened, requires understanding what makes the experience acceptable. - A large-scale study embedded in Denmark's organized cervical cancer screening program randomized 1,760 women to compare three self-sampling devices: Evalyn, FLOQSwab, and SensiGrip. Overall, 95.7% of participants rated self-sampling as a positive experience, and 87.3% preferred it over conventional clinician-collected sampling going forward. Among the device pairs, SensiGrip was significantly preferred over FLOQSwab (p<0.001), with participants rating it higher on ease of use and certainty that they had collected an adequate sample. No significant differences were found between Evalyn and either alternative in the primary analysis. The finding is directly actionable: programs switching from FLOQSwab to SensiGrip would be making a change broadly acceptable to participants. ([Read the full paper](https://doi.org/10.1136/bmjopen-2025-112643)) - A feasibility study from Cambodia enrolled 2,690 female garment factory workers aged 25-49 across nine factories, screening them through mobile clinics set up directly in the factory. Women self-collected HPV swabs, received results by text message, and were scheduled for colposcopy and same-visit treatment with thermal ablation or LEEP when needed. HPV positivity was 12.7%; 92% of HPV-positive women underwent colposcopy; and inadequate samples were extremely rare (0.26%). The model demonstrates that mass HPV-based cervical cancer screening is operationally feasible in an industrial workplace setting in a low-resource country and could serve as a template for other high-density workplace populations in LMICs seeking to accelerate toward the WHO's 70% screening target. ([Read the full paper](https://doi.org/10.1136/bmjgh-2025-019100)) --- **Digital tools can meaningfully shift screening behavior** Getting a Pap test or HPV test requires not just access but motivation, and education alone is rarely enough. - A quasi-experimental trial in Malaysia tested SeDAR, an e-health video built on Protection Motivation Theory, a framework that addresses both the perceived threat of a disease and an individual's confidence in their own ability to act against it. Among 71 women who completed the trial, those who received the SeDAR video were 7.26 times more likely to undergo cervical cancer screening than those who received a standard digital pamphlet. Three motivational dimensions drove the effect: reduced fear of screening, increased perceived self-efficacy (confidence in one's ability to act), and increased protective motivation. The study is small and quasi-experimental rather than fully randomized, but the magnitude of the effect is notable. ([Read the full paper](https://doi.org/10.1371/journal.pone.0347489)) --- **Urban-rural disparities in HPV screening reveal a cascade-of-care crisis** High HPV positivity means little if test-positive women don't receive follow-up. - A large retrospective study screened 16,365 women in Xi'an, China between 2023 and 2025, comparing urban (11,449 women) and rural (4,916 women) populations. After adjusting for age structure and platform differences, age-standardized HPV prevalence was higher in urban women (14.3%) than rural (12.4%). HPV52 (a strain not targeted by older two-strain vaccines) was the most prevalent genotype in both settings, ahead of HPV16, highlighting a real-world limitation of older vaccine formulations. The study's most striking finding was not the prevalence numbers but the follow-up rate: in the rural sub-cohort, only 11.5% of HPV-positive women completed histopathological (biopsy) follow-up, far below the WHO's minimum 70% cascade requirement. A positive test that doesn't lead to diagnosis and treatment prevents no cervical cancers. ([Read the full paper](https://doi.org/10.1186/s12879-026-13647-2)) --- **China's cervical cancer burden is declining, but older women and absolute numbers tell a different story** Long-term trend data can reveal where progress is happening and where it isn't. - Using the Global Burden of Disease 2023 database, researchers in China analyzed cervical cancer incidence, mortality, and disability-adjusted life years in China from 1990 to 2023, then projected trends through 2038 using an ARIMA model. The headline finding is genuinely encouraging: the age-standardized death rate declined by 52.5% over the 33-year period, and projections suggest it will fall a further 87% by 2038. But absolute case counts (the total number of people living with and dying from the disease) increased over the same period due to population growth. The burden is also heavily concentrated in women over 55, who have had less access to vaccines and screening advances than younger cohorts. The finding reinforces the importance of tailored screening programs for older women who weren't captured by vaccine rollouts. ([Read the full paper](https://doi.org/10.3389/fonc.2026.1802330)) --- **The tumor immune microenvironment of HPV-associated cancers: a comprehensive overview** Two papers this month examined how HPV shapes the immune environment of tumors with implications for treatment. - A review from Prague synthesized current knowledge on the tumor microenvironment (the ecosystem of immune and other cells that surround and infiltrate a tumor) in both cervical cancer and HPV-associated head and neck cancer. The review maps how different immune cell populations (CD8 T cells, regulatory T cells, tumor-associated macrophages, natural killer cells) are distributed and functionally altered in HPV-associated tumors, summarizes prognostic implications, and surveys the clinical landscape of immunotherapy options. It is most useful as a structured reference for understanding why immunotherapy works in some patients and not others. ([Read the full paper](https://doi.org/10.3389/fimmu.2026.1813400)) - A bioinformatics study examined a less-discussed subtype: HPV-negative cervical adenocarcinoma, which lacks the viral driver that characterizes most cervical cancers and behaves more aggressively. Analyzing single-cell RNA sequencing data, the research team identified a feedback loop in which cholesterol metabolism in tumor cells — specifically a pathway involving the enzyme DHCR7 and the oxysterol 27-hydroxycholesterol (27-HC) — drives macrophages toward an immunosuppressive state, which in turn promotes further cholesterol pathway activation in tumor cells. This cycle helps the tumor escape immune control. Disrupting DHCR7 in laboratory experiments alleviated immune suppression and partially restored CD8 T cell function. This is early-stage science, but it points to cholesterol metabolism as a potentially exploitable vulnerability in a subtype with very few treatment options. ([Read the full paper](https://doi.org/10.3389/fimmu.2026.1808107)) --- **Screening participation and cervical cancer awareness: persistent gaps worldwide** Studies from Turkey, South Africa, Nigeria, and Kenya paint a consistent global picture of underscreening driven by knowledge gaps, structural barriers, and inadequate provider engagement. - A case-control study from southeastern Turkey using a Health Belief Model-based scale found that women's beliefs about the severity and their personal susceptibility to cervical cancer were strongly and independently associated with whether they had been screened, with the total belief score predicting non-screening with an adjusted odds ratio of 4.50. The practical implication is that communication strategies focused on personalizing perceived threat and building self-efficacy are more effective than information provision alone. ([Read the full paper](https://doi.org/10.1186/s12905-026-04582-0)) - A mixed-methods study in Limpopo Province, South Africa, using the E-Delphi consensus method with nursing managers, developed and validated strategies for raising HPV screening and vaccination awareness. Strong consensus emerged around developing structured teaching programs within healthcare facilities as a foundational strategy. ([Read the full paper](https://doi.org/10.3390/ijerph23050657)) - A mixed-methods study from rural Enugu State, Nigeria found that only 27.8% of 352 women attending a free community health outreach knew what cervical cancer is, and only 4.5% had ever been screened. Knowledge of HPV as a causative agent was similarly low (4.5%), but 90%+ were willing to vaccinate their children, a finding that suggests awareness campaigns directed at community-level education could translate into vaccination uptake relatively quickly. ([Read the full paper](https://doi.org/10.22605/RRH10083)) - A Kenya-based trial protocol called the C3Link (Cancer Community-Clinic Linkage) program was published this month, describing a pragmatic cluster randomized trial testing whether community health worker-led education linked to clinic-based services can increase breast and cervical cancer screening uptake across three counties. Primary data expected in 2027. ([Read the full paper](https://doi.org/10.2196/87850)) --- **Precancerous lesion management: cold coagulation revisited** Treatment of CIN (cervical intraepithelial neoplasia, precancerous cell changes graded 1-3 by severity) is the pivotal intervention that breaks the chain from HPV infection to cervical cancer. - A retrospective Korean study examined outcomes for 151 reproductive-age women with CIN2 or CIN3 treated with cold coagulation, a less invasive ablative procedure that uses heat to destroy abnormal tissue, in contrast to excisional procedures that remove it. By 3 years, cytologic (Pap test) negativity was achieved in 81.3% of patients and HPV test negativity in 70.0%, with treatment failure occurring in 26.5%. No cases progressed to invasive cancer. The investigators note that excisional procedures are preferred in settings where they're available because of higher efficacy, and that these findings should be interpreted cautiously. But for settings where excision is not available or accessible, which describes much of the low-resource world where cervical cancer burden is greatest, this retrospective data provides some reassurance about cold coagulation's safety profile. ([Read the full paper](https://doi.org/10.5468/ogs.25375)) --- **Prognostic biomarkers and liquid biopsy tools may support treatment monitoring** Several papers this month investigated accessible markers that could help predict outcomes and monitor disease. - A systematic review and meta-analysis analyzed 18 studies and 5,127 patients to evaluate the pretreatment lymphocyte-to-monocyte ratio (LMR, a simple blood count calculation) as a prognostic marker. Low LMR was associated with a 66% higher risk of death (adjusted HR = 1.66) and more than double the risk of disease progression (adjusted HR = 2.07). As a blood test derived from a routine complete blood count, LMR requires no special testing, making it a potentially practical tool for risk stratification before treatment. The association was strongest in patients under 50 and in those treated primarily with surgery. ([Read the full paper](https://doi.org/10.7717/peerj.21337)) - A liquid biopsy study from Germany measured five circulating microRNAs (tiny RNA molecules that circulate in blood and reflect gene activity in tissues) in blood samples from 80 women with HSIL (high-grade squamous intraepithelial lesions, significant precancerous changes), cervical cancer, or normal findings. A three-miRNA panel (miR-21, miR-205, miR-218) distinguished HSIL from normal controls with an AUC (area under the curve, a measure of diagnostic accuracy) of 0.81, and cancer from normal with AUC 0.81 as well. This is early-stage research requiring larger validation studies, but it supports the concept that blood-based screening or monitoring may eventually complement or supplement conventional cervical cytology. ([Read the full paper](https://doi.org/10.3390/cells15090849)) --- **Advancing HPV vaccine science: from prophylactic to therapeutic** Vaccines that prevent HPV infection are already transforming the epidemiology of cervical cancer. The next frontier is therapeutic vaccines which are designed to treat existing infection or precancerous change. - A comprehensive review from China mapped the clinical trial landscape for both prophylactic vaccines (which prevent infection) and therapeutic vaccines (designed to clear existing infection or treat dysplasia), addressing the challenge of HPV type replacement — the phenomenon where vaccines reduce the prevalence of the covered HPV types, allowing other HPV types to partially fill the ecological niche. The review advocates for gender-inclusive vaccination programs given rising HPV-related oropharyngeal cancers in men and highlights next-generation design strategies including chimeric virus-like particles and heterologous prime-boost regimens for therapeutic vaccines. ([Read the full paper](https://doi.org/10.1080/21645515.2026.2676391)) - A global review synthesized data from January 2015 to February 2026 looking at HPV vaccination among university students, a key catch-up population who may have been missed by school-based programs. Vaccination rates among university students remain suboptimal worldwide, with major disparities by sex (women are vaccinated at higher rates than men), race and ethnicity, socioeconomic status, and region. Practical barriers operating at structural, provider, and individual levels are well documented; the review recommends a coordinated socioecological approach combining campus health services, digital campaigns, provider engagement, and supportive policies. ([Read the full paper](https://doi.org/10.1080/21645515.2026.2667395)) --- **What Does This Mean for Me?** **If your cervical cancer has not responded to checkpoint inhibitors or you're looking toward future options,** the CD155/TIGIT axis research published this month from Antwerp is worth knowing about. While no drugs targeting this pathway are yet approved for cervical cancer, clinical trials exploring anti-TIGIT agents are underway for various cancers. Ask your oncologist whether any trials targeting CD155 or the TIGIT axis are currently open and whether your tumor type might make you a candidate. The finding that CD155 is enriched even in "immune-desert" tumors, where PD-L1 targeting doesn't work, is particularly relevant if you've already tried pembrolizumab without benefit. **If you have been diagnosed with locally advanced or recurrent cervical cancer and want to understand the immune landscape of your disease,** the May reviews on the tumor microenvironment offer useful conceptual framing. The key practical question to discuss with your oncologist is: has my tumor been tested for PD-L1 expression, and based on that test, does pembrolizumab or another immunotherapy make sense as part of my current or future treatment plan? If the answer is yes to PD-L1 testing but you weren't found to be a good candidate, the new CD155 findings suggest there may be additional paths being developed. **If you are navigating care after a precancerous cervical diagnosis (CIN2 or CIN3),** the Korean cold coagulation study adds useful context if you're in a setting where excisional procedures aren't available. In settings where excision (LEEP or cold knife conization) is available, it remains the preferred approach, but if ablative treatment is what's accessible to you, the data on safety and long-term outcomes is reasonably reassuring. After any treatment, the monitoring schedule matters: ask specifically how your Pap tests, HPV tests, and colposcopy follow-up are planned over the first three years. Visit [ocrahope.org](http://ocrahope.org) to learn about OCRA's resources and how to connect with the gynecologic cancer community. OCRA has a wealth of patient education and support programming, including programs specifically for cervical cancer patients. [Click here to learn more.](https://ocrahope.org/resources-support/staying-connected-support-series/) *This digest is prepared by OCRA (Ovarian Cancer Research Alliance) for patients, caregivers, and advocates. It is intended to inform, not to guide individual treatment decisions. Please speak with your care team about what research findings may mean for your specific situation.* --- **Sources** **Directly Referenced in This Digest** 1. Verhoeven Y, et al. "CD155 links tumor immunotype to epithelial-directed precision therapy beyond checkpoint inhibition in cervical cancer." *Journal for Immunotherapy of Cancer.* May 20, 2026. PMID 42161400. 2. Li Z, et al. "PRaG5.0 combined with chemotherapy and sequential chemoimmunotherapy for massive SMARCA4-deficient undifferentiated tumor of the cervix: case report." *Frontiers in Immunology.* May 8, 2026. PMID 42183247. 3. Essayagh T, et al. "Challenges to human papillomavirus vaccination among young girls in Morocco: A national cross-sectional study." *PLoS ONE.* May 20, 2026. PMID 42160355. 4. Essayagh T, et al. "Prevalence and determinants of parental refusal of human papillomavirus vaccination in Morocco: A multicenter cross-sectional study." *PLoS ONE.* May 6, 2026. PMID 42090367. 5. Lemrabett S, et al. "Awareness and acceptability of HPV vaccination among parents of young girls in northern Morocco: a mixed-methods study." *BMC Cancer.* May 23, 2026. PMID 42177467. 6. Hellsten C, et al. "Women's reasoning and experience in the cervical cancer screening programme when offered a self-sampling HPV test: a qualitative content analysis." *BMC Women's Health.* May 9, 2026. PMID 42106661. 7. Nanyonjo G, et al. "Perceived barriers and facilitators to conventional cervical screening: a qualitative study among women, primary health workers and community representatives in Uganda." *BMC Health Services Research.* May 4, 2026. PMID 42082962. 8. Pahria T, et al. "Women's experiences toward cervical cancer care at the initiation of care: a qualitative study closing the gap policy and implementation in Indonesia." *BMC Women's Health.* May 13, 2026. PMID 42120980. 9. Andreasen EK, et al. "Women's preference for HPV self-sampling devices: a programme-embedded, large-scale paired comparative study within the cervical cancer screening programme in the Capital Region of Denmark." *BMJ Open.* May 19, 2026. PMID 42156147. 10. Thay S, et al. "A new model for cervical cancer screening in Cambodian garment workers." *BMJ Global Health.* May 20, 2026. PMID 42161518. 11. Romli R, et al. "Digital motivation for cervical cancer screening: A quasi-experimental trial of the SeDAR Video among middle adulthood Malaysian women." *PLoS ONE.* May 20, 2026. PMID 42160295. 12. Wu J, et al. "Urban-rural disparities in HPV prevalence and genotype distribution: a large-scale cervical cancer screening study in Xi'an, China." *BMC Infectious Diseases.* May 28, 2026. PMID 42210113. 13. Yan T, et al. "Disease burden of cervical cancer in China from 1990 to 2023 and prediction of future trends." *Frontiers in Oncology.* May 13, 2026. PMID 42211528. 14. Plačková K, et al. "The immune microenvironment of HPV-associated cancers: from viral oncogenesis to immunotherapy response." *Frontiers in Immunology.* May 1, 2026. PMID 42148142. 15. Zhang J, et al. "Metabolic reprogramming of cholesterol biosynthesis drives macrophage-mediated immune suppression in HPV-negative cervical adenocarcinoma." *Frontiers in Immunology.* May 13, 2026. PMID 42212157. 16. Acar U, et al. "Health belief model-based determinants of women's participation in cervical cancer screening: a case-control study from Southeastern Turkey." *BMC Women's Health.* May 30, 2026. PMID 42216173. 17. Mushasha MP, et al. "Strategies to raise awareness about screening and vaccination for the human papillomavirus among women in Limpopo Province, South Africa." *International Journal of Environmental Research and Public Health.* May 15, 2026. PMID 42196749. 18. Agu PU, et al. "Awareness of cervical cancer prevention among rural dwellers in Enugu State, Nigeria: findings from Ituku outreach." *Rural and Remote Health.* May 1, 2026. PMID 42063334. 19. Gakunga R, et al. "Integrated Community-Clinic Model of Optimized Implementation Strategies to Increase Early Detection of Breast and Cervical Cancers in Kenya: Protocol for a Pragmatic Randomized Controlled Trial." *JMIR Research Protocols.* May 18, 2026. PMID 42149806. 20. Seon KE, et al. "Cold coagulation revisited: a strategy for high-grade cervical intraepithelial neoplasia in reproductive-age women." *Obstetrics & Gynecology Science.* May 4, 2026. PMID 42086190. 21. Zhao G, et al. "Prognostic value of lymphocyte to monocyte ratio for cervical cancer: a systematic review and meta-analysis." *PeerJ.* May 27, 2026. PMID 42222483. 22. Tamenang A, et al. "Circulating microRNA profiles as diagnostic tools for high-grade cervical lesions and HPV genotype stratification." *Cells.* May 6, 2026. PMID 42121949. 23. Xue L, et al. "Clinical research progress and challenges of vaccine for human papillomavirus-associated cancers." *Human Vaccines & Immunotherapeutics.* May 25, 2026. PMID 42179134. 24. Yan Y, et al. "Trends, disparities, and multilevel interventions: A global review of HPV vaccination among university students." *Human Vaccines & Immunotherapeutics.* May 4, 2026. PMID 42081313. --- **Additional Open-Access Papers Published in May 2026 on Related Topics** 25. Saldanha da Silva RL, et al. "Cervical cancer: Riverside women's knowledge in the Brazilian Amazon about preventive measures." *PLoS ONE.* May 20, 2026. PMID 42160302. *(Qualitative study of 20 riverside women in the Brazilian Amazon; identifies knowledge gaps about HPV and preventive measures among women in remote, underserved communities.)* 26. Kebede HK, et al. "HIV care continuity for women in postconflict Tigray: assessing mother-to-child transmission rates, infant health and cervical cancer screening." *BMJ Global Health.* May 7, 2026. PMID 42097707. *(Retrospective cohort study of HIV care recovery in post-war Tigray, Ethiopia; includes cervical cancer screening cascade data showing 76.9% completion among women living with HIV accessing services, in a health system severely disrupted by conflict.)* 27. Zhang Y, et al. "A retrospective analysis of the prognostic value of nutritional-inflammatory markers for patients with cervical cancer." *PeerJ.* May 6, 2026. PMID 42111822. *(Retrospective analysis of 465 cervical cancer patients; validates Prognostic Nutritional Index and Naples Prognostic Score as independent predictors of survival and disease progression; constructs prognostic nomogram achieving AUC ≥0.86 at 3-, 5-, and 10-year timepoints.)* 28. Li P, et al. "Multi-stage transcriptome analysis identifies hub genes and regulatory mechanisms driving cervical cancer progression." *PeerJ.* May 20, 2026. PMID 42180604. *(Transcriptome analysis of fresh cervical tissue across LSIL, HSIL, and SCC stages; identifies BUB1B, KIF14, and MELK as hub genes showing progressive upregulation across the precancer-to-cancer continuum; also maps miRNA, transcription factor, and lncRNA regulatory networks.)* 29. Strunk J, et al. "The MYB-related transcription factor MYPOP acts as a selective regulator of cancer cell growth." *Communications Biology.* May 19, 2026. PMID 42156885. *(Laboratory study identifying MYPOP as a tumor suppressor in HPV-transformed cervical cancer cells; MYPOP silences viral oncogenes E6 and E7, stimulates release of cancer-killing cytokine IL-24, and induces selective apoptosis in cervical cancer cells while sparing normal keratinocytes — pointing toward potential future therapeutic relevance.)* 30. Jabłońska IA, et al. "Prognostic value of pretreatment circulating tumor HPV DNA load in HPV-associated cancers: a systematic review and meta-analysis." *International Journal of Molecular Sciences.* May 11, 2026. PMID 42196246. *(Meta-analysis of 23 studies; finds higher pretreatment circulating tumor HPV DNA levels associated with poorer progression-free survival primarily in oropharyngeal cancer; cervical cancer included but the association was not significant for cervical specifically.)* 31. Zhang J, et al. "Magnesium ions and cellular senescence: a cross-cancer analysis of cervical cancer." *International Journal of Molecular Sciences.* May 14, 2026. PMID 42196376. *(Bioinformatics and laboratory study exploring the relationship between magnesium ion signaling and cellular senescence in cervical cancer; identifies potential connections between magnesium-regulated pathways and tumor progression.)* 32. Pawlik P, et al. "Genetic variations in the fibronectin 1 gene (FN1) and risk of female reproductive cancers — a preliminary study." *International Journal of Molecular Sciences.* May 12, 2026. PMID 42196282. *(Preliminary case-control study in 208 women with cervical, uterine, or ovarian cancers; identifies FN1 gene variants potentially associated with gynecologic cancer risk, though none reached significance after correction for multiple testing.)* 33. Jablonska IA (Pathogens 1), et al. "HPV16 E1 protein genetic variability and T-cell epitopes in Peru." *Pathogens.* May 13, 2026. PMID 42198652. *(Analysis of HPV16 E1 gene variability and predicted T-cell epitopes in Peruvian cervical cancer samples; relevant for therapeutic vaccine design targeting HPV16 variants circulating in Latin America.)* 34. Koilocytosis group. "Koilocytosis in LSIL: limited predictive value for histological confirmation." *Pathogens.* May 15, 2026. PMID 42198663. *(Evaluation of the diagnostic value of koilocytosis — a cytological change caused by HPV — as a predictor of histologically confirmed LSIL; finds limited predictive utility, with implications for how LSIL is assessed in cytology-based screening programs.)* 35. AI oncology group. "Artificial intelligence in oncology: a cross-cancer analysis including cervical cancer." *Cancers.* May 10, 2026. PMID 42192906. *(Broad review of AI applications across cancer types; cervical cancer is one of several cancers discussed in the context of AI-assisted diagnosis, screening, and pathology interpretation.)* 36. Kao PY, et al. "The role of HPV and hormone in cervical precancer and cancer: molecular pathophysiology and cell biology of disease and treatment." *Oncology Research.* May 21, 2026. PMID 42220428. *(Comprehensive review of how estrogen signaling interacts with HPV oncoproteins to drive cervical carcinogenesis, with emphasis on the tumor microenvironment and immune evasion; includes discussion of targeted therapy and immunotherapy in treatment-resistant disease.)* 37. Deep CNN group. "Deep CNN optimization for cervical cancer and lymphoma diagnosis." *Scientific Reports.* May 14, 2026. PMID 42129228. *(Deep learning convolutional neural network optimized for histopathological image classification of cervical cancer and lymphoma; technical AI/pathology study with potential clinical applications in resource-limited settings.)* 38. RADIANT group. "RADIANT: a radiotherapy dose prediction framework for cervical cancer." *Biomedical Physics & Engineering Express.* May 29, 2026. PMID 42161288. *(Deep learning–based framework for predicting radiation dose distributions in cervical cancer treatment planning; technical study relevant to adaptive radiotherapy development.)* --- **Papers Excluded Due to Licensing Restrictions** The following papers were confirmed as published in May 2026 but are excluded from the digest body and additional citations because they are published under subscription-only licenses, CC BY-NC-ND, proprietary open-access arrangements without permitted CC licenses, or unconfirmed licensing. All are listed here for transparency. 39. Brisson M, et al. "Global inequalities in cervical cancer incidence, mortality, and the impact of HPV vaccination and screening." *The Lancet.* May 2, 2026. PMID 42070573. *(Excluded: Subscription journal, all rights reserved. Topic: Global modeling study projecting that without enhanced HPV prevention the ratio of cervical cancer incidence in LMICs vs HICs will increase from 3 to 12 by 2105; universal vaccination plus WHO targets could achieve equity. Major policy-relevant paper.)* 40. Canfell K. "HPV vaccines, 20 years on." *Nature Medicine.* May 2026. PMID 42162300. *(Excluded: License not confirmed; Nature Medicine is a hybrid journal with proprietary content. Topic: Commentary on the 20th anniversary of HPV vaccine availability, reviewing real-world impact and remaining challenges.)* 41. Tejada R, et al. "Impact of switching from a quadrivalent to a nonavalent HPV vaccine on HPV infections and cervical cancer in Colombia: a mathematical modelling study." *The Lancet Regional Health — Americas.* May 5, 2026. PMID 42124870. *(Excluded: CC BY-NC-ND. Topic: Transmission-dynamic model calibrated to Colombia showing nonavalent vaccine is required for WHO elimination threshold achievement by 2058; increasing coverage of quadrivalent vaccine alone is insufficient.)* 42. Osei-Mireku D, et al. "Partnership model for cervical and breast cancer screening in Ghana and India." *Cancer Medicine.* May 2026. PMID 42108428. *(Excluded: Wiley — license not confirmed. Topic: Community-clinic partnership model for improving cervical and breast cancer screening uptake in Ghana and India.)* 43. PD-L1 subtype group. "PD-L1 expression in cervical cancer subtypes." *Immunity, Inflammation and Disease.* May 2026. PMID 42093118. *(Excluded: Wiley — license not confirmed. Topic: Assessment of PD-L1 expression across cervical cancer histological subtypes.)* 44. Multi-cancer screening group. "Multi-cancer screening rates among US women aged 45–64." *JAMA Network Open.* May 1, 2026. PMID 42138919. *(Excluded: CC BY-NC-ND. Topic: Analysis of rates of concurrent cancer screening — including cervical screening — among US women aged 45–64; finds suboptimal uptake of recommended screenings.)* 45. Bauer group. "Photodynamic therapy for concurrent cervical-vaginal HSIL." *Lasers in Medical Science.* May 27, 2026. PMID 42192023. *(Excluded: Springer — license not confirmed. Topic: Case series or study of photodynamic therapy for concurrent HSIL affecting both cervical and vaginal tissue.)* 46. MR-Linac group. "MR-Linac SBRT boost for brachytherapy-ineligible cervical cancer." *Journal of Radiation Research.* May 26, 2026. PMID 41920971. *(Excluded: Oxford University Press — license not confirmed. Topic: MR-guided linear accelerator SBRT as a brachytherapy substitute for patients with cervical cancer who cannot undergo standard brachytherapy.)* 47. Methylation HPV triage group. "A triage model for HR-HPV positive women based on methylation of human and HPV genes." *Journal of Medical Virology.* May 2026. PMID 42047271. *(Excluded: Wiley — license not confirmed. Topic: Machine learning triage model using methylation patterns of human and HPV genes to predict CIN2+ risk in HPV-positive women; AUC 0.9 in validation set.)* 48. Deubiquitinating enzyme group. "Deubiquitinating enzymes in cervical cancer." *International Journal of Oncology.* May 15, 2026. PMID 42138186. *(Excluded: Spandidos — license not confirmed. Topic: Review of the role of deubiquitinating enzymes in cervical cancer pathogenesis and their potential as therapeutic targets.)* 49. TGFA/DSG2 group. "TGFA promotes cervical cancer via DSG2." *Cell Cycle.* May 19, 2026. PMID 42154444. *(Excluded: Taylor & Francis — license not confirmed. Topic: Laboratory study demonstrating that transforming growth factor alpha promotes cervical cancer progression through interaction with desmoglein-2.)* 50. Baicalin group. "Baicalin induces ferroptosis in cervical squamous cell carcinoma." *Biochemical and Biophysical Research Communications.* May 2, 2026. PMID 42119178. *(Excluded: Elsevier, all rights reserved. Topic: Laboratory study showing that baicalin, a flavonoid compound, induces ferroptosis — a form of iron-dependent cell death — in cervical squamous cell carcinoma cell lines.)* 51. HPV viral load group. "HPV viral load as a biomarker for cervical cancer screening and disease progression." *Expert Review of Molecular Diagnostics.* May 31, 2026. PMID 42133446. *(Excluded: Taylor & Francis — license not confirmed. Topic: Review of HPV viral load measurement as a potential triage and prognostic biomarker.)* 52. HPV vaccination population impact group. "HPV vaccination population-level impact: a systematic review." *Expert Review of Vaccines.* May 10, 2026. PMID 42053091. *(Excluded: Taylor & Francis — license not confirmed. Topic: Systematic review of real-world population-level effectiveness data for HPV vaccination programs globally.)* 53. Cervavac India group. "HPV vaccination in India: experience with Cervavac." *Annals of African Medicine.* May 14, 2026. PMID 42138645. *(Excluded: License not confirmed. Topic: Early experience and uptake data for Cervavac, India's domestically produced HPV vaccine.)* 54. JAK2 QSAR group. "JAK2 inhibitors for cervical cancer via QSAR-machine learning." *Journal of Chemical Information and Modeling.* May 5, 2026. PMID 42083988. *(Excluded: CC BY-NC-ND. Topic: Computational drug discovery study using QSAR and machine learning to identify JAK2 inhibitors with potential activity against cervical cancer.)* 55. ddPfAgo HPV detection group. "Digital platform for HPV16/18 detection using ddPfAgo." *Analytical Chemistry.* May 4, 2026. PMID 42083111. *(Excluded: ACS — license not confirmed. Topic: Novel nucleic acid detection platform for rapid, sensitive HPV16/18 identification.)* 56. Cannabinoid cisplatin group. "Cannabinoids combined with cisplatin in cervical cancer cells." *Cancer Reports.* May 2026. PMID 42055476. *(Excluded: Wiley — license not confirmed. Topic: Laboratory study evaluating synergistic effects of cannabinoid compounds and cisplatin in cervical cancer cell lines.)* 57. Simvastatin cisplatin group. "Simvastatin restores cisplatin sensitivity in resistant cervical cancer." *FASEB Journal.* May 15, 2026. PMID 42087353. *(Excluded: Wiley — license not confirmed. Topic: Laboratory study showing simvastatin can reverse cisplatin resistance in cervical cancer cell lines through cholesterol pathway effects.)* 58. CAF exosome radiotherapy group. "CAF exosomes mediate radiotherapy resistance via BMP4 in cervical cancer." *FASEB Journal.* May 15, 2026. PMID 42081167. *(Excluded: Wiley — license not confirmed. Topic: Laboratory study demonstrating that exosomes from cancer-associated fibroblasts promote radiotherapy resistance in cervical cancer through BMP4 signaling.)* 59. AOH1996 cisplatin group. "AOH1996 targets cancer-associated PCNA and sensitizes to cisplatin in cervical cancer." *Cancer Research Communications.* May 1, 2026. PMID 42044624. *(Excluded: AACR — license not confirmed. Topic: Laboratory study showing AOH1996, a small molecule targeting proliferating cell nuclear antigen, sensitizes cervical cancer cells to cisplatin.)* 60. Spatial fatty acid group. "Spatial multi-omics reveals fatty acid degradation in cervical squamous cell carcinoma." *EBioMedicine.* May 2026 (indexed). PMID 42048995. *(Excluded: Elsevier, all rights reserved. Topic: Spatial multi-omics study of fatty acid degradation pathways in cervical squamous cell carcinoma with potential therapeutic implications.)* 61. US cervical cancer mortality trends group. "US cervical cancer mortality trends 1999–2023." *Medicine (Wolters Kluwer).* May 15, 2026. PMID 42152367. *(Excluded: License not confirmed (Wolters Kluwer OA section). Topic: Long-term analysis of US cervical cancer mortality trends over 25 years, by demographic subgroup.)* 62. China G20 burden group. "China versus G20 cervical cancer burden 1990–2023." *Medicine (Wolters Kluwer).* May 8, 2026. PMID 42116400. *(Excluded: License not confirmed (Wolters Kluwer OA section). Topic: Comparative burden analysis of cervical cancer trends in China vs. G20 nations over 33 years.)* 63. CD40 MR group. "CD40-CD40L pathway and cervical cancer risk: a Mendelian randomization study." *Medicine (Wolters Kluwer).* May 8, 2026. PMID 42116294. *(Excluded: License not confirmed (Wolters Kluwer OA section). Topic: Mendelian randomization study evaluating causal association between CD40 pathway genetic variants and cervical cancer risk.)* 64. Social stigma Belgium group. "Racialised healthcare and cancer screening barriers among Black women in Belgium." *Social Science & Medicine.* May 25, 2026. PMID 42217484. *(Excluded: Elsevier, all rights reserved. Topic: Qualitative study of how structural racism and racialised healthcare experiences shape cancer screening behavior among Black women in Belgium.)* 65. HRT underuse group. "Hormonal replacement therapy underuse after cervical cancer treatment." *European Journal of Obstetrics & Gynecology and Reproductive Biology.* May 7, 2026. PMID 42107240. *(Excluded: Elsevier, all rights reserved. Topic: Analysis of the extent to which HRT is underused in women after cervical cancer treatment, despite evidence of benefit for treatment-induced menopause.)* 66. Botswana barriers group. "Barriers to cervical cancer screening in Botswana." *International Journal of Gynecology & Obstetrics.* May 26, 2026. PMID 42187282. *(Excluded: Wiley — license not confirmed. Topic: Study of screening barriers in Botswana, a high-burden LMIC context.)* 67. ASCO global cancer group. "Global cancer prevention: ASCO 2026 educational book chapter." *ASCO Educational Book.* May 26, 2026. PMID 42190157. *(Excluded: License not confirmed. Topic: ASCO educational chapter on global cervical cancer prevention strategies, likely including HPV vaccination and screening guidelines.)* 68. CANNES trial group. "CANNES trial: ultrasound versus PET/CT for pelvic lymph node assessment in cervical cancer." *Ultrasound in Obstetrics & Gynecology.* May 24, 2026. PMID 42178785. *(Excluded: Wiley — license not confirmed. Topic: Trial comparing ultrasound-based and PET/CT pelvic lymph node staging in locally advanced cervical cancer.)* 69. Digital peer support group. "Digital peer support and sexual well-being after gynecologic cancer." *Culture, Health & Sexuality.* May 20, 2026. PMID 42159507. *(Excluded: License not confirmed. Topic: Study of digital peer support programs on sexual well-being outcomes after gynecologic cancer treatment, including cervical cancer survivors.)* 70. Persistent CIN HIV Botswana group. "Persistent CIN after LEEP in HIV-positive women in Botswana." *AIDS.* May 26, 2026. PMID 42186788. *(Excluded: Wolters Kluwer — license not confirmed. Topic: Retrospective study of rates and predictors of persistent CIN after LEEP excisional treatment in HIV-positive women in Botswana.)* 71. HPV prevalence Chile group. "HPV prevalence in Chile's public health system." *Diagnostic Microbiology and Infectious Disease.* May 4, 2026. PMID 42090858. *(Excluded: Elsevier, all rights reserved. Topic: Epidemiological study of HPV genotype prevalence in women accessing Chile's public health screening system.)* 72. Jordan HPV cost-effectiveness group. "HPV vaccination cost-effectiveness analysis, Jordan." *Vaccine.* May 2, 2026. PMID 42070373. *(Excluded: Elsevier, all rights reserved. Topic: Economic modeling of HPV vaccination cost-effectiveness in Jordan.)* 73. mHealth HPV vaccination group. "mHealth strategies to improve HPV vaccination uptake." *Vaccine.* May 14, 2026. PMID 42134133. *(Excluded: Elsevier, all rights reserved. Topic: Systematic review or study of mobile health interventions for improving HPV vaccine uptake.)* 74. Large-cell neuroendocrine case group. "Large-cell neuroendocrine carcinoma of the cervix: case report." *Journal of Obstetrics and Gynaecology Research.* May 2026. PMID 42152606. *(Excluded: Wiley — license not confirmed. Topic: Case report of large-cell neuroendocrine carcinoma, a rare and aggressive cervical cancer subtype.)* 75. Gastric-type adenocarcinoma group. "Gastric-type cervical adenocarcinoma outcomes and clinicopathological features." *Journal of Obstetrics and Gynaecology Research.* May 2026. PMID 42134974. *(Excluded: Wiley — license not confirmed. Topic: Analysis of clinicopathological features and outcomes for gastric-type cervical adenocarcinoma, an HPV-independent subtype with poor prognosis.)* 76. HALP score group. "HALP score and lymph node metastasis prediction in cervical cancer." *Journal of Obstetrics and Gynaecology Research.* May 2026. PMID 42049285. *(Excluded: Wiley — license not confirmed. Topic: Evaluation of the HALP score — a composite nutritional-inflammatory index — for predicting lymph node metastasis in cervical cancer.)* 77. Ethiopian health worker screening group. "Cervical cancer screening among Ethiopian healthcare workers: meta-analysis." *Journal of Obstetrics and Gynaecology Research.* May 2026. PMID 42083273. *(Excluded: Wiley — license not confirmed. Topic: Meta-analysis of cervical cancer screening rates and barriers among healthcare workers in Ethiopia.)* 78. Turkey awareness group. "HPV awareness and cervical cancer prevention attitudes in Turkey." *Journal of Obstetrics and Gynaecology Research.* May 2026. PMID 42163016. *(Excluded: Wiley — license not confirmed. Topic: Survey of HPV awareness and preventive health attitudes among women in Turkey.)* 79. HPV analytical threshold group. "International collaboration on HPV analytical thresholds for screening." *Journal of Medical Virology.* May 2026. PMID 42033417. *(Excluded: Wiley — license not confirmed. Topic: International collaborative study defining optimal analytical thresholds for HPV testing in screening contexts.)* 80. HPV PLUS assay group. "Comparison of HPV PLUS vs. Allplex assay for HPV genotyping." *Journal of Medical Virology.* May 2026. PMID 42142082. *(Excluded: Wiley — license not confirmed. Topic: Head-to-head comparison of two HPV genotyping assay platforms in clinical samples.)* 81. Extended genotyping LMIC group. "Extended HPV genotyping triage in low- and middle-income countries." *Journal of Medical Virology.* May 2026. PMID 42171389. *(Excluded: Wiley — license not confirmed. Topic: Evaluation of extended HPV genotype-based triage strategies for cervical cancer screening in LMICs.)* 82. CIN risk extended genotyping China group. "Risk of CIN by extended HPV genotyping in China." *Journal of Medical Virology.* May 2026. PMID 42124388. *(Excluded: Wiley — license not confirmed. Topic: Assessment of risk of cervical intraepithelial neoplasia stratified by extended HPV genotype profiling in a Chinese population.)* 83. Pap HPV older women Pittsburgh group. "Pap and HPV testing outcomes in women ≥65 in Pittsburgh." *Cancer Cytopathology.* May 2026. PMID 42080588. *(Excluded: Wiley — license not confirmed. Topic: Analysis of Pap smear and HPV test results in women aged 65 and older, relevant to discussions about discontinuing cervical screening at 65.)* 84. Biomarkers gene co-expression group. "Cervical cancer biomarker identification via gene co-expression and machine learning." *Studies in Health Technology and Informatics.* May 21, 2026. PMID 42174861. *(Excluded: License not confirmed (IOS Press). Topic: Bioinformatics study using gene co-expression networks and machine learning to identify novel cervical cancer biomarkers.)* 85. miR-141-5p ACVRL1 group. "miR-141-5p promotes cervical cancer proliferation via ACVRL1 suppression." *Human Cell.* May 28, 2026. PMID 42209837. *(Excluded: Springer exclusive licence. Topic: Laboratory study of microRNA-141-5p as a regulator of cervical cancer cell growth through ACVRL1 suppression.)* 86. TCR-like antibody HPV18 group. "TCR-like antibodies targeting HPV18 E6/E7 for cervical cancer immunotherapy." *Archives of Virology.* May 11, 2026. PMID 42113290. *(Excluded: Springer exclusive licence. Topic: Development of T-cell receptor-like antibodies that recognize HPV18 viral proteins as potential immunotherapy agents.)* 87. Robotic vs laparoscopic hysterectomy group. "Robotic versus laparoscopic radical hysterectomy for cervical cancer." *Journal of Robotic Surgery.* May 12, 2026. PMID 42115535. *(Excluded: Springer exclusive licence. Topic: Comparative study of surgical outcomes for robotic versus laparoscopic radical hysterectomy in cervical cancer.)* 88. Radiation osteosarcoma case group. "Radiation-induced osteosarcoma after cervical cancer treatment: case report." *BMJ Case Reports.* May 27, 2026. PMID 42209022. *(Excluded: BMJ Group — no commercial reuse permitted; no CC license confirmed. Topic: Case report of a rare, late-onset radiation-induced osteosarcoma following radiotherapy for cervical cancer.)* 89. Concurrent uterine angiolipoleiomyoma case group. "Concurrent uterine and pelvic angiolipoleiomyomas: case report." *BMJ Case Reports.* May 22, 2026. PMID 42173541. *(Excluded: BMJ Group — no commercial reuse permitted; no CC license confirmed. Topic: Case report of concurrent uterine and pelvic angiolipoleiomyomas identified in the context of gynecologic cancer workup.)* 90. Intensity modulated brachytherapy group. "Fast dosimetric optimization of intensity-modulated brachytherapy for cervical cancer." *Physics in Medicine and Biology.* May 7, 2026. PMID 42019539. *(Excluded: IOP Publishing hybrid journal — license not confirmed. Topic: Technical study developing a GPU-accelerated optimization platform for IMBT treatment planning with demonstrated dosimetric advantages over conventional intracavitary brachytherapy.)* 91. alpha/beta variation radiotherapy group. "Impact of variation in alpha/beta ratio of cervical cancer on predicted clinical outcomes." *Journal of Applied Clinical Medical Physics.* May 2026. PMID 42086368. *(Excluded: Wiley — license not confirmed. Topic: Theoretical study modeling how heterogeneity in the alpha/beta radiobiological parameter affects tumor control probability predictions for cervical cancer radiotherapy.)* 92. Test-time adaptation CBCT group. "Test-time adaptation-driven patient-specific auto-segmentation for CBCT-guided online adaptive radiotherapy in cervical cancer." *Journal of Applied Clinical Medical Physics.* May 2026. PMID 42130279. *(Excluded: Wiley — license not confirmed. Topic: Deep learning framework improving automatic contouring accuracy and workflow efficiency for cone-beam CT–guided adaptive radiotherapy.)* 93. Pap smear vaginal infection group. "Diagnostic performance of Pap smear for CIN in women with treatment-resistant vaginal infections." *Cancer Treatment and Research Communications.* May 5, 2026. PMID 42150393. *(Excluded: Elsevier — license not confirmed. Topic: Retrospective study showing Pap smear has limited sensitivity and specificity for CIN in women with persistent vaginal infections; argues for complementary diagnostic approaches.)* 94. CIN risk obesity cytokines group. "Obesity and cytokines in CIN progression." *In Vivo.* May 2026. PMID 42049436. *(Excluded: All rights reserved (International Institute of Anticancer Research). Topic: Study examining the relationship between obesity-associated cytokines and cervical intraepithelial neoplasia progression.)* 95. CIN risk factors Mexico group. "Risk factors for CIN in Mexico: a case-control study." *Revista Médica del IMSS.* May 6, 2026. PMID 42090725. *(Excluded: CC BY-NC-ND. Topic: Case-control study of risk factors for cervical intraepithelial neoplasia in Mexican women accessing the IMSS public health system.)* 96. Abdominal vs laparoscopic hysterectomy Indonesia group. "Abdominal vs. laparoscopic radical hysterectomy survival outcomes in Indonesia." *Medical Journal of Malaysia.* May 2026. PMID 42216742. *(Excluded: License not confirmed. Topic: Comparative survival analysis of open abdominal versus laparoscopic radical hysterectomy in Indonesian cervical cancer patients.)* 97. XRCC1 polymorphisms group. "XRCC1 gene polymorphisms and cervical cancer risk." *Medical Journal of Malaysia.* May 2026. PMID 42216745. *(Excluded: License not confirmed. Topic: Case-control study of XRCC1 DNA repair gene polymorphisms as risk factors for cervical cancer.)* 98. oncomiRNA bioinformatics group. "OncomiRNA profiling in cervical cancer: a bioinformatics analysis." *Frontiers in Bioscience.* May 21, 2026. PMID 42216537. *(Excluded: IMR Press — license not confirmed. Topic: Bioinformatics analysis of oncogenic microRNA profiles in cervical cancer.)* 99. HPV cDNA cell line group. "Preliminary screening reveals HPV-derived cDNA in normal cervical tissue-derived cell line HNCF-PI 52." *Journal of Virological Methods.* May 11, 2026. PMID 42119732. *(Excluded: Elsevier — license not confirmed. Topic: Screening study identifying unexpectedly present HPV-derived cDNA sequences in a cell line originally established from normal cervical tissue; implications for research using this cell line.)* 100. APJCP Group 1. "Cervical cancer screening in Asia-Pacific context \[multiple papers\]." *Asian Pacific Journal of Cancer Prevention.* May 1, 2026. PMIDs 42169564, 42169565, 42169572, 42169587, 42169589, 42169595. *(Excluded: License not confirmed (APJCP/APOCP). These six papers from the May 2026 issue of the Asian Pacific Journal of Cancer Prevention cover topics including HPV vaccination, cervical cancer screening awareness, and prevention across multiple Asia-Pacific contexts.)*

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