Cervical cancer (CC) is one of the leading causes of mortality in women worldwide, where the main risk factor is infection with the human papillomavirus (HPV). This type of cancer is a significant public health problem, especially in regions with limited access to health care and vaccination programs. In recent years, the crucial link between the cervicovaginal microbiota and immune homeostasis has been highlighted, emphasizing its protective role against infections, including HPV. The cervicovaginal microbiota is composed mostly of bacteria of the Lactobacillus genus, important for female health and pH maintenance. Many studies have documented the role of vaginal dysbiosis in patients with intraepithelial lesions and CC. This dysbiosis is characterized by an increase in anaerobic bacteria as well as an increase in the microbial diversity, which create an inflammatory microenvironment that contributes to tissue damage and HPV persistence, favoring progression to invasive cancer. Recently, the use of probiotics in oral and topical forms as well as the vaginal microbiota transplantation have been explored to restore the balance of the vaginal microbiota and enhance the immune response against HPV. However, a lack of global standardization and ethical issues have had an impact on the formal development of these interventions. We propose that modulation of the vaginal microbiota by probiotics represents a valuable complementary strategy against CC. Future research should focus on clinical trials evaluating the efficacy of probiotics in modulating the vaginal microbiome and their impact on CC incidence and progression.
