New research has revealed that Schistosoma haematobium, a parasitic infection affecting millions globally, can trigger cancer-related gene activity in the cervical lining, with changes becoming even more pronounced after treatment. Presented at ESCMID Global 2025, this pivotal study sheds new light on how this often-overlooked parasitic disease may contribute to cervical cancer risk at the molecular level.
Schistosomiasis is a widespread parasitic disease which is particularly prevalent in regions with poor access to clean water and sanitation. S haematobium, one of the main species responsible for human schistosomiasis, infects over 110 million people worldwide by depositing eggs that infiltrate the urinary and reproductive tracts. While this parasite is recognized as a risk factor for the development of bladder cancer, its potential role in cervical cancer has remained poorly understood.
Study Details and Genetic Findings
In this study, researchers analyzed cervical tissue samples from 39 Tanzanian women with (n = 20) and without (n = 19) S haematobium infection. Women with S haematobium infection received treatment with the anthelmintic praziquantel, and samples were collected at baseline and 4 to 12 months post-treatment. Through RNA sequencing and gene expression analysis, cancer-related pathways linked to infection were identified. Nine genes were expressed differently between women with S haematobium infection and women not infected with S haematobium, 23 genes changed in women who cleared the infection after treatment, and 29 genes differed between women post-treatment and those never infected.
Among the nine genes most significantly altered between women with S haematobium infection and without infection, four were linked to cancer:
- BLK proto-oncogene: A tyrosine kinase that drives cell proliferation and can contribute to tumor formation when dysregulated
- Long Intergenic Non-Protein Coding RNA 2084: A prognostic marker in head and neck and colon cancers, influencing gene regulation tied to tumor progression
- Trichohyalin: Involved in keratin complex formation and upregulated in certain cancers
- TCL1 family AKT coactivator A: Promotes cell survival and proliferation, and is linked to T- and B-cell lymphomas.
Post-treatment, certain cancer-related biological pathways became more active, particularly those involved in inflammation, tissue remodeling, and the breakdown of protective barriers in the cervix. These changes were linked to increased blood vessel formation, activation of tumor-related processes, and reduced apoptosis.
“The findings suggest that infection may trigger molecular changes that make women more vulnerable to cancer-related processes in the cervix, especially after treatment,” explained leady study author Anna Maria Mertelsmann, MD, a researcher at University Hospital Zurich and Weill Cornell Medicine. “One particularly concerning observation was the downregulation of genes responsible for maintaining cervical tissue integrity, including claudins and tight junction proteins. This loss of protective function could facilitate human papillomavirus (HPV) infection and persistence, a major risk factor for cervical cancer.”
“Our research shows that women who received praziquantel treatment exhibited more genetic changes linked to cancer than those with an active infection,” Dr. Mertelsmann added. “This raises critical questions about the long-term effects of treatment and highlights the need for careful post-treatment monitoring.”
This study serves as an important first step in understanding the role of S haematobium in cervical cancer, and a larger study following 180 women over 12 months is currently underway to confirm these findings. Future research will also explore whether women who have had schistosomiasis are at greater risk of cervical cancer due to long-term HPV infections.
Dr. Mertelsmann and her team stressed the need for greater awareness of female genital schistosomiasis (FGS), as many women with S haematobium are also affected by this difficult-to-diagnose condition. “Women diagnosed with S haematobium should be closely monitored for early signs of cervical tissue abnormalities,” she emphasized. She also suggested that additional treatments—such as anti-inflammatory or immune-modulating therapies—could help counteract the harmful effects seen after treatment. Moreover, widespread HPV vaccination could play a crucial role in reducing cervical cancer risk for women affected by schistosomiasis.
Disclosure: For full disclosures of all study authors, visit ESCMID Global.
