Current Concept of Bacterial Vaginosis in Cervical Cancer

Abstract

Invasive cervical cancer is often associated with bacterial vaginosis (BV) caused by both non-pathogenic and pathogenic bacteria and other microorganisms. BV goes un-noticed during the clinical course of cervical cancer. The incidence of BV is very high among women from developing countries with poor genital hygiene. Maintainence of normal vaginal ecosystem in healthy vagina is through control of optimal ratio between non-pathogenic and pathogenic organisms. Cervical cancer causes disruption of the normal vaginal and cervical mucosa leading to alteration of ratio between commensals and pathogenic organisms. The natural vaginal microflora is being dominated by lactobacilus species compared to pathogenic aerobic and anaerobic microorganisms. Disruption of vaginal microenvironment leads to change in vaginal flora and associated inflammation. There are very limited literature available on the exact incidence of BV in cervical cancer patients. Increased nitrosamine content in BV could possibly progress to higher DNA damage, change in cytokine profile thus compromise immune defence against human papilloma virus infection. Both radiotherapy and chemotherapy are potential immunosuppressive agent thus could facilitate spread of endogenous bacteria to manifest as poor outcome to treatment secondary to tissue hypoxia and hypoperfusion. This article is a review of current literature associated with BV in cervical cancer.




J Clin Gynecol Obstet. 2014;3(1):1-7
doi: http://dx.doi.org/10.14740/jcgo175w