Researchers compared cervical microbial communities in Texas and Puerto Rico and found differences by location and dysplasia status.
The study explored HPV and the cervical microbial ecosystem, without establishing that particular bacteria cause dysplasia.
HPV infection does not lead to cervical dysplasia or cancer in every woman. Some infections clear naturally; others persist alongside abnormal cervical cell changes.
The cervical microbial environment is one factor being investigated as a possible contributor to these different outcomes.
A US research team analyzed samples from 296 women and found differences in microbial composition by residence and cervical dysplasia status. The study was published in Scientific Reports.
296 participants, including 85 with dysplasia
The collaboration included the University of Texas MD Anderson Cancer Center and the University of Puerto Rico. Participants had received gynecological care in Texas or Puerto Rico.
The sample comprised 80 non-Hispanic White women and 98 Hispanic women living in Texas, and 118 Hispanic women living in Puerto Rico.
Of the participants, 211 (71%) were a high-risk normal group: they had a history of abnormal cervical cytology or a positive HPV result, but no dysplasia at the time of assessment. The remaining 85 (29%) had low- or high-grade cervical dysplasia.
The researchers used 16S ribosomal RNA sequencing of cervical samples to compare bacterial communities.
Different locations, different microbial communities
Microbial composition and diversity differed by place of residence.
Hispanic women in Texas had higher values on some diversity measures than comparison groups. Differences were also observed in measures describing how evenly microorganisms were distributed.
Cervical and vaginal microbial communities can be dominated by Lactobacillus or contain a more diverse mixture of bacteria. CST III and CST IV-B were prominent community-state types in this study, with distributions varying by location and disease status.
Greater microbial diversity is not automatically a sign of better cervical health. Unlike the gut, the female reproductive tract is often associated with healthier conditions when particular lactobacilli predominate.
Looking beyond HPV positivity alone
HPV 16 was detected in 45 participants, approximately 15% of the sample. Other high-risk types were detected in 98 women, approximately 33%.
HPV 16 is closely linked to cervical cancer, but detection of a high-risk type does not establish that dysplasia or cancer will develop.
The study examined microbial ecosystems alongside viral status.
Participants were classified using HPV type and cervical cytology and histology results. Comparing their microbial communities supported studying the surrounding ecosystem as well as viral infection when investigating dysplasia.
Cause or consequence?
The relationship between microbial changes and dysplasia requires particularly careful interpretation.
The study did not demonstrate that a specific microorganism directly causes dysplasia or persistent HPV. It could not distinguish whether microbial changes preceded lesions or whether existing cervical changes altered the microbial environment.
This was a cross-sectional study, measuring cervical condition and microorganisms at one point in time. Longitudinal research is needed to examine changes after HPV infection and whether they affect dysplasia onset or progression.
Participants came from particular regions and clinical populations at increased risk of cervical abnormalities, limiting generalization to all women.
Nevertheless, the microbial ecosystem is a relevant area of investigation. Further research must clarify whether microbial analysis can help assess persistent infection or progression risk.
Current evidence is insufficient to conclude that cervical microbiome tests or probiotic products alone prevent or treat HPV infection or dysplasia. Established assessment uses HPV testing, cervical cytology and, where indicated, colposcopy and biopsy according to clinical guidance.
This study provides foundational information about a complex relationship, rather than establishing a new cause of cervical dysplasia.
Related reading: Related reporting on HPV and vaginal conditions.
Source: “The cervical microbiome in Hispanic populations in Texas and Puerto Rico with and without cervical dysplasia,” published in Scientific Reports in 2026. The collaboration included the University of Texas MD Anderson Cancer Center and the University of Puerto Rico, with D’Shaunique Walters, Molly B. El Alam and colleagues. Cervical samples from 296 women were analyzed in relation to HPV and dysplasia status. DOI: 10.1038/s41598-026-74196-x.
The illustration was created using generative AI (ChatGPT, OpenAI).
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