Cervical cancer is usually associated with the human papillomavirus (HPV), a sexually transmitted disease that accounts for nearly all cervical cancer cases. HPV types 16 and 18 have been found to account for more than 70% of cervical cancer cases worldwide. HPV vaccination and cervical screening schemes have had a remarkable impact in lowering the incidence of HPV-associated cervical cancer, particularly in developed countries but can cervical cancer happen without HPV?

Surprisingly, yes—but only rarely. Between 5.5% and 11% of cervical cancers are HPV-negative, and these tend to be missed until advanced stages. This article discusses what we now know about HPV-negative cervical cancers, why they are difficult to diagnose, and what it all means for prevention and treatment in the future.

Dominant Role of HPV in Cervical Cancer

HPV is by far the most frequent cause of cervical cancer and is responsible for almost 99% of cases. The virus is generally transmitted through sexual contact and can remain in the body for years before resulting in abnormal cell growth in the cervix.

In nations such as Australia, where screening and vaccination programs are well organized, the majority of cervical cancer cases can be traced to HPV. Of the 900 women who develop cervical cancer annually in Australia, nearly all have been attributed to this virus. The two most lethal types of HPV—16 and 18—are accountable for as much as 80% of the cases.

However, in a small percentage of cases, no detectable HPV infection is present. These are the uncommon but important outliers that researchers and clinicians are working increasingly harder to comprehend.

What is HPV-Negative Cervical Cancer?

HPV-negative cervical cancers occur in an estimated 5.5% to 11% of all cases worldwide. These are uncommon subtypes of adenocarcinomas, including:

• Clear cell carcinoma
• Mesonephric carcinoma
• Gastric-type adenocarcinoma

In a few instances, tumors that are HPV-negative at presentation can be and were once HPV-positive, yet the virus is no longer detectable because of tumor progression or testing limitations. In any case, such cancers tend to act differently than HPV-positive tumors—and present formidable diagnostic challenges.

Why HPV-Negative Cases Go Undetected?

One of the biggest challenges to tackling HPV-negative cervical cancers is that existing screening tools—both the Pap test and the newer Cervical Screening Test (CST)—are intended to pick up HPV-associated abnormalities. Therefore, HPV-negative tumors usually go undetected early on.

Lacking an independent test that can specifically pick up these uncommon types, many women won't be diagnosed until they start noticing symptoms, including:

• Unexplained vaginal bleeding
• Pelvic pain
• Painful sex
• Irregular discharge

These symptoms usually manifest later, hence HPV-negative cervical cancers usually have a poorer prognosis. A meta-analysis of 17 studies with more than 2,800 patients revealed that the outcomes for HPV-positive cervical cancers are substantially better than those for HPV-negative cancers. Both earlier detection and biologic differences in tumor behavior are likely to be the reasons for this.

Potential Risk Factors Of Cervical Cancer Beyond HPV

Although HPV is still the leading cause of cervical cancer, various factors can contribute to elevating one's risk, particularly in HPV-negative patients:

Smoking: Duplicates the risk of cervical cancer by subjecting cervical cells to carcinogens.

Long-term oral contraceptive use: Prolonged use can raise the risk, although risk dissipates after stopping pills.

Multiple births: Multiple full-term pregnancies can raise the vulnerability through hormonal fluctuations and prolonged exposure to HPV.

Weakened immune system: Diseases such as HIV or immunosuppressive drugs may weaken the body and make it less likely to resist infections and abnormal cell growth.

Family history: There may be a genetic component that contributes to susceptibility.

Chlamydia infection: Long-term infections caused by this bacterium may raise the risk.

Poor diet: Inadequate fruit and vegetable intake has been linked with increased cancer risk from less protective antioxidants and vitamins.

Nevertheless, risk factors above are modifiers and not primary causes. In the case of HPV-negative cervical cancer, there is no single cause, and studies on possible genetic or environmental cause are under way.

Diagnosis of HPV-Negative Cervical Cancer

Since there is no screening test for HPV-negative cervical cancers, diagnosis typically only happens after symptoms arise. Physicians use:

• Pelvic exams
• Biopsies
• Imaging tests like MRI or CT scans

By the point of discovery, the cancer is typically so advanced that the treatment becomes more complex and survival rates lower.

This delay in detection underscores a critical imperative for biomarker identification, cutting-edge imaging, and better awareness both within the healthcare community and among the general public.

Are We Underestimating the Role of HPV?

Some authors believe that the rate of HPV-negative cervical cancers could be overestimated because of false negatives, i.e., cases with the presence of the virus that are not detectable at the moment of testing. This may be explained by:

• Low viral load
• Sampling errors
• Short period of time between infection and testing

This hypothesis is put forward on the grounds that the actual number of true HPV-negative cases may be less than reported, though more sophisticated diagnostic methods are required to support this.

How To Minimize Risk Of Cervical Cancer?

HPV-positive or HPV-negative, there are steps to take that lower the risk of developing cervical cancer overall:

Get vaccinated: The HPV vaccine protects against the most risky types of the virus.

Go for regular screenings: Although they don't catch HPV-negative cancers, Pap and HPV tests are still important for the early detection of most.

Stop smoking: Reducing tobacco use reduces exposure to carcinogens.

Practice safe sex: Wear condoms to reduce the risk of sexually transmitted diseases.

Eat a balanced diet: Provide a nutrient-rich diet with high levels of antioxidants.

Women who have any unusual gynecological symptoms—no matter what their screening history is—should see a healthcare provider early.

Though HPV-negative cervical cancer is uncommon, it poses special detection, diagnostic, and therapeutic challenges. These instances remind us that cervical cancer is not a monolith and highlight the need for ongoing research, improved screening technologies, and heightened awareness.

Heart disease remains one of the leading causes of death globally, and while technology has evolved to the point where predicting heart attacks is possible, the medical world still struggles to put this into practice. Experts point to both promise and pitfalls in predictive cardiology, revealing why such life-saving tech is not yet a mainstream reality.

The Tech Is Here, But We Are Not Using It Enough

Dr. Vikrant B. Khese, Cardiologist at Jehangir Hospital, Pune, says the idea that we can predict heart attacks before they happen is both “exciting and frustrating, because while the technology exists, its real-world implementation remains limited.”

He explains that artificial intelligence (AI) and machine learning (ML) have incredible potential in this field. These tools can analyse vast datasets, such as blood pressure, lipid profiles, ECGs, imaging, and even genetic markers, to uncover patterns that might be invisible to the human eye. “These tools can detect subtle risk factors that may be missed in routine clinical practice. However, several challenges continue to hold us back,” he says.

One of the biggest concerns is the source of the data feeding these algorithms. “The majority of AI models are trained on Western datasets that do not reflect the unique genetic, environmental, and lifestyle factors of Indian or Asian populations. This creates a mismatch, resulting in lower accuracy and reliability for non-Western patients.”

Dr. Khese adds that cardiovascular disease is deeply multifactorial. It is not just about clinical metrics. “Stress, socioeconomic status, cultural diet patterns, air pollution, and unstructured physical activity all influence risk but are difficult to quantify in a dataset. AI still struggles with these intangible but crucial variables.”

And even when predictive tools are developed, another hurdle lies in the healthcare system’s ability to use them. “Data-driven predictions can only be as good as the data input. In India, inconsistent electronic medical records, underreporting, and fragmented healthcare systems make it harder to gather high-quality longitudinal data, limiting the AI's learning potential.”

Crucially, there is also a behavioural gap. “Even when prediction tools exist, they are not routinely used by clinicians due to scepticism, lack of training, or workflow disruption. Bridging the gap between innovation and implementation is a major hurdle.”

According to Dr. Khese, technology must complement clinical judgement, not replace it. “AI is a powerful tool but not a standalone solution. Until we combine high-quality, representative data with clinical wisdom and system-level integration, the promise of predicting heart attacks before they happen will remain underutilised. The future lies in synergy; technology must empower doctors, not replace them.”

Prediction Tools Exist—But We’re Waiting for Symptoms

Dr. Vijay D'Silva, Medical Director of White Lotus International Hospital and Clinical Advisor and Mentor of Heartnet India, backs this view and draws attention to major international trials. “Research from the University of Oxford has suggested that a global trial of an AI tool that can predict the 10-year risk of heart attack has shown that in about 45 per cent of patients with chest pain, treatment could be improved,” he shares.

“Early detection of cardiac risk allows timely treatment and monitoring that can help reduce the mortality rate,” he says, explaining that most coronary blockages are asymptomatic. “Some present with chest, arm or jaw pain on exertion (angina pectoris). Few present as a heart attack or sudden death. People seek treatment after a heart attack when the damage is already done.”

According to Dr. D’silva, “With the help of the right tools, it is now possible to predict a heart attack before it occurs.” Among these tools are blood tests, ECGs, and advanced risk calculators such as the AHA PREVENT calculator, ASCVD Risk Calculator Plus, QRISK3, and SCORE2.

He points out how the 2023 AHA PREVENT calculator estimates 10-year cardiovascular risk in individuals aged 30 to 79, and 30-year risk in adults aged 30 to 59. “Early-stage detection of CVD minimises the cost and also reduces the CVD mortality rate,” he says.

This tool divides patients into four risk categories, each with its own treatment strategy:

• Low risk (<5%): Maintain healthy lifestyles and reassess every five years.
• Borderline risk (5–7.4%): Lifestyle changes and monitoring of risk-enhancing factors like BP, sugar, weight and lipids. CAC scoring can further stratify risk. Annual reassessment recommended.
• Intermediate risk (7.5–19.9%): Calls for lifestyle management, preventive medication (statins or aspirin), stress testing and CT coronary angiogram. Yearly reassessment is needed.
• High risk (≥20%): Requires intensive lifestyle changes, pharmacotherapy, imaging and close follow-up.

Despite these advances, Dr D'Silva says, “The gap lies in implementation. Most people still wait for the symptoms to appear before seeing a doctor. Heart attacks, unfortunately, strike without any warning, especially in women and younger patients, where symptoms can be atypical.”

He stresses that predictive cardiology is not yet standard in clinical practice. “People who are at risk seek care when symptoms arise. But in cardiology, symptoms often come too late. Up to 50 per cent of heart attack victims had no prior warning signs.”

Why Risk Calculators Are NotFoolproof

• Patients with LDL cholesterol ≥190 mg/dL
• Those with familial hypercholesterolemia
• Patients with type 1 diabetes
• People with other risk-enhancing factors like family history of early cardiovascular disease, metabolic syndrome, chronic kidney disease, chronic inflammatory diseases (psoriasis, RA, lupus), or early menopause

The Way Forward

Dr. D'silva concludes, “The ability to predict heart attacks is advancing continuously, but we need public awareness and equitable access to make predictive cardiology more standard.”

In short, we can predict heart att but until we normalise risk screening, improve data systems, and bridge the clinical gap, too many heart attacks will continue to catch people and systems off guard.

When strands clog your shower drain or your brush looks full every time you run it through your hair, panic is a natural response. Hair loss, or alopecia, is not just a cosmetic concern; it often hints at something deeper. And yet, thanks to internet half-truths and old wives’ tales, myths about alopecia spread faster than a viral meme. On World Alopecia Day, we turn to experts to separate fact from fiction while spotlighting the hidden medical conditions that might be behind the hair fall.

It is Not Just "Shedding Season": Medical Reasons Behind Hair Loss

Autoimmune Disorders (Alopecia Areata):

Hormonal Imbalances (Thyroid Disorders and PCOS):

Nutritional Deficiencies:

The good news? “Early diagnosis and treatment of these conditions can help restore hair growth and prevent permanent damage,” he assures.

Wigging Out Over Myths

Myth 1: “Only men experience alopecia.”

“While male pattern baldness is more commonly discussed, women are equally susceptible to alopecia due to hormonal imbalances, thyroid issues, and nutritional deficiencies,” says Dr Gangurde. Yes, ladies lose hair too and not just from brushing too hard.

Myth 2: “Stress alone is responsible for hair loss.”

While stress is definitely not good for your scalp’s health, it is not the lone cause. “Alopecia usually has multiple triggers, including genetics, autoimmune conditions, and underlying medical issues,” explains Dr Gangurde. Translation: stressing about stress causing hair fall might make things worse.

Myth 3: “Alopecia is always permanent and untreatable.”

This one might be the most damaging myth of all. “Many forms of hair loss, especially those caused by hormonal or nutritional factors, are reversible with timely medical intervention,” says Dr Gangurde. PRP therapy, medications, and lifestyle changes can all turn things around if you act early enough.

Do Not Just Shed Tears, Seek Help

If your hair has been thinning or falling out in clumps, resist the urge to DIY it with oils, serums, or social media hacks. “If you experience sudden or persistent hair loss, consult a dermatologist or trichologist promptly,” advises Dr Gangurde. “Early intervention can address the root cause, prevent progression, and in many cases, restore healthy hair growth.” Remember that alopecia is not just a surface-level issue. And with the right diagnosis, it is often more fixable than you think.

The 2025 flu season has turned out to be unlike any other in recent memory. This year, the flu season is marked by record-setting infections, multiple viral peaks, vaccine mismatches, and an overstretched healthcare system.

According to the Centers for Disease Control and Prevention (CDC), this year’s influenza activity is the most intense since the 2009 swine flu pandemic, with over 80 million estimated illnesses and rising. What’s driving this intensity, and what should the public know about prevention and symptom management?

Let’s break down what makes this flu season so severe and what it means for your health.

A Season Like No Other: What Makes 2025 Different?

In most years, flu activity in the U.S. typically follows a predictable pattern, starting in October, peaking between December and February, and fading by April. But the 2024–2025 season has defied that rhythm.

Cases surged past the national baseline in December and then, unexpectedly, peaked again in February, a second wave that blindsided doctors and public health experts.

As of March 2025, the CDC had reported an estimated 37 million influenza infections, 480,000 hospitalizations, and 21,000 deaths. Hospitalizations, in fact, reached their highest levels in 15 years.

One key driver? A mismatch between circulating flu strains and this year’s vaccine. The dominant strains: H1N1 and H3N2, accounted for more than 99% of cases.

H3N2, in particular, is known for mutating quickly and evading immune responses, and only about half of circulating H3N2 samples matched well with vaccine antibodies, according to CDC surveillance data.

Post-Pandemic Immune Gap

Another reason this year’s flu is hitting so hard: our immune systems are still catching up.

During the height of the COVID-19 pandemic, widespread masking, social distancing, and school closures suppressed not just SARS-CoV-2 but also seasonal flu and other common respiratory viruses. While that helped in the short term, it reduced community-level immunity over time, especially among children, who typically build natural resistance through repeated exposures.

“Young children who were toddlers or preschoolers during the pandemic missed early exposures to flu viruses,” explained experts at the nonprofit group Families Fighting Flu. “Now they’re in school, more socially active, and more vulnerable.”

The CDC reported a troubling spike in pediatric flu deaths this season with 216 fatalities, making it the deadliest flu season for children outside of a pandemic year. Neurological complications such as seizures and hallucinations also rose among young patients.

A Shift in Viral Dominance

Another unusual trend: COVID-19 has taken a back seat this winter

Unlike previous years when COVID-19 variants dominated respiratory illness charts, flu has surged ahead as the top driver of doctor visits and hospitalizations. This could be due to a shift in viral dominance, changing weather patterns, or differences in immunity buildup. According to the CDC, nearly 8% of all outpatient visits are currently for flu-like symptoms, much higher than what’s typical for this time of year.

Vaccine Fatigue and Gaps in Coverage

Vaccination remains the strongest tool we have to fight influenza, but uptake has been stagnant, or worse, declining, in key groups.

As of April 2025:

• Only 49.2% of children and 46.7% of adults had received the flu vaccine
• Among pregnant women, that number dropped to 38%
• Medicare beneficiaries aged 65+ had just 48.3% coverage
• And overall, nearly 9.2 million fewer doses were administered compared to the pre-pandemic 2019–2020 season

Barriers like vaccine hesitancy, misinformation, racial and ethnic disparities in healthcare access, and fewer flu shot clinics in rural areas continue to widen the gap.

What Are the Symptoms in 2025?

The 2025 flu has shown typical but often more intense symptoms than in previous years. Here’s what to look out for:

• Sudden onset fever
• Severe body aches and chills
• Sore throat and persistent cough
• Nasal congestion
• Diarrhea and vomiting (more frequent in children)
• Extreme fatigue
• Headache
• In some children, neurological symptoms like confusion or seizures

These symptoms may overlap with COVID-19 or RSV, but tend to come on faster and hit harder in flu cases this season.

How Long Do Symptoms Last?

For most healthy people, flu symptoms begin 1 to 4 days after exposure and typically last about 5 to 7 days. However, fatigue and cough may linger for up to two weeks.

You’re considered most contagious in the first 3 to 4 days after symptoms start but can continue to spread the virus up to a week later. The CDC recommends staying home until you’ve been fever-free for at least 24 hours without medication.

Vaccinated individuals may experience milder or shorter symptoms, but those with underlying conditions, young children, and older adults may have longer recoveries and higher risk of complications.

Can the Flu Cause Serious Health Problems?

Yes, especially in people with weakened immune systems, chronic illnesses, or no prior flu immunity.

Possible complications include:

• Pneumonia
• Ear and sinus infections
• Exacerbation of asthma or heart disease
• Life-threatening conditions requiring ICU care

This is why experts stress that prevention remains the best medicine.

How to Protect Yourself and Your Family

Here’s how to lower your risk during the remainder of the 2025 season:

• Get vaccinated, even now. It may still protect against circulating strains
• Wash your hands often with soap and water
• Avoid touching your face in public settings
• Cover your mouth and nose when coughing or sneezing
• Stay home if you’re unwell to prevent spreading the virus