Human papillomavirus (HPV) infections are definitively linked to cervical cancer, with strong evidence showing that HPV is the necessary cause of this disease. This association is consistent across all cervical cancer cases worldwide, and there are no alternative hypotheses for its aetiology. HPV is the first identified necessary cause of a human cancer, meaning cervical cancer cannot develop without persistent HPV DNA. Cervical cancer remains the second most common cancer in women globally, but it is preventable. In developed regions with established cytology screening, HPV testing should be added to screening protocols to improve accuracy. In areas without effective cytology programs, HPV testing should be considered as an alternative. Vaccination against high-risk HPV types is the most effective and feasible preventive measure for cervical cancer. Regulatory agencies should evaluate scientific evidence to inform public health policies. The association between HPV and cervical cancer has been confirmed by numerous studies, including case-control studies, cohort studies, and a randomized trial. These studies show that HPV infection precedes cervical cancer by several years and that sexual transmission is the primary mode of acquisition. HPV DNA is detected in 90–100% of cervical cancer cases, compared to 5–20% in controls. The causal relationship has been recognized by international review bodies since the 1990s, and HPV is considered the first necessary cause of a human cancer. The Hill criteria for causality, including strength, consistency, specificity, temporality, and biological gradient, support the causal relationship between HPV and cervical cancer. The association is consistent across multiple studies and populations. HPV is associated with various cancers, including those of the vulva, vagina, anal canal, and penis. The specificity of HPV in causing cervical cancer is evident, as certain HPV types are strongly linked to specific cancers. Temporality is also supported, with HPV infections preceding cervical cancer by several years. HPV testing has shown value in identifying high-grade lesions and improving screening accuracy. Studies indicate that HPV testing is more sensitive than cytology in detecting high-grade lesions. The persistence of HPV DNA is a strong predictor of cervical cancer progression. Preventive interventions, such as HPV vaccination, are effective in reducing the risk of cervical cancer. The role of sexual behavior, including the number of sexual partners and age at first intercourse, is a key determinant of HPV infection. Male circumcision has been shown to reduce the risk of HPV infection and cervical cancer in women. Overall, the evidence strongly supports the causal relationship between HPV and cervical cancer, and public health strategies should focus on prevention, screening, and vaccination to reduce the burden of this disease.Human papillomavirus (HPV) infections are definitively linked to cervical cancer, with strong evidence showing that HPV is the necessary cause of this disease. This association is consistent across all cervical cancer cases worldwide, and there are no alternative hypotheses for its aetiology. HPV is the first identified necessary cause of a human cancer, meaning cervical cancer cannot develop without persistent HPV DNA. Cervical cancer remains the second most common cancer in women globally, but it is preventable. In developed regions with established cytology screening, HPV testing should be added to screening protocols to improve accuracy. In areas without effective cytology programs, HPV testing should be considered as an alternative. Vaccination against high-risk HPV types is the most effective and feasible preventive measure for cervical cancer. Regulatory agencies should evaluate scientific evidence to inform public health policies. The association between HPV and cervical cancer has been confirmed by numerous studies, including case-control studies, cohort studies, and a randomized trial. These studies show that HPV infection precedes cervical cancer by several years and that sexual transmission is the primary mode of acquisition. HPV DNA is detected in 90–100% of cervical cancer cases, compared to 5–20% in controls. The causal relationship has been recognized by international review bodies since the 1990s, and HPV is considered the first necessary cause of a human cancer. The Hill criteria for causality, including strength, consistency, specificity, temporality, and biological gradient, support the causal relationship between HPV and cervical cancer. The association is consistent across multiple studies and populations. HPV is associated with various cancers, including those of the vulva, vagina, anal canal, and penis. The specificity of HPV in causing cervical cancer is evident, as certain HPV types are strongly linked to specific cancers. Temporality is also supported, with HPV infections preceding cervical cancer by several years. HPV testing has shown value in identifying high-grade lesions and improving screening accuracy. Studies indicate that HPV testing is more sensitive than cytology in detecting high-grade lesions. The persistence of HPV DNA is a strong predictor of cervical cancer progression. Preventive interventions, such as HPV vaccination, are effective in reducing the risk of cervical cancer. The role of sexual behavior, including the number of sexual partners and age at first intercourse, is a key determinant of HPV infection. Male circumcision has been shown to reduce the risk of HPV infection and cervical cancer in women. Overall, the evidence strongly supports the causal relationship between HPV and cervical cancer, and public health strategies should focus on prevention, screening, and vaccination to reduce the burden of this disease.