THE LION’S ROAR: LIV JAGRELL ON METAL, FEROCITY, AND THE MORAL FIRE THAT DRIVES LIV SIN

by Alex S Johnson 

When Liv Jagrell entered my zoom studio for The Kandy Fontaine Show, the atmosphere shifted the way it only does when someone who has lived their art — not performed it, not approximated it, but lived it — enters the room. I introduced her the way she deserved: “My special guest in the studio with me today is none other than Liv Jagrell from Liv Sin, formerly of Sister Sin, a truly iconic metal singer, songwriter, performer… you have a stage presence that is just fully ferocious and committed.” Because she does. She’s one of those rare front‑people whose intensity isn’t an act; it’s a state of being.

I told her about that moment at a Judas Priest show in Florida years ago, when a guy — maybe Brazilian, maybe Argentinian — grabbed me and said, “You’re my brother, you’re my brother.” That’s metal. That’s the thing. And Liv knew it instantly. She just said, “Yeah, you know,” because she does know. She’s lived it.

So I asked her what first captured her about metal energy, and she said, “I think that, well, the metal energy I had to say was thanks to Pantera.” She remembered discovering them at fifteen or sixteen, around 1995–96. “I discovered Pantera, and that hooked me in.” Before that, she’d been immersed in Nirvana and Courtney Love. “Courtney Love was my first idol because I thought that she was super cool… she can be a rock star. I can be a rock star.” Nirvana and Courtney Love got her into music, into wanting to play, and then Pantera sealed her fate: “This is the music I want to do.”

I remembered when grunge came online and hit metal “like a hammer.” Ronnie James Dio playing the Troubadour during Angry Machines, looking a little bitter because suddenly nobody was playing classic metal. Liv remembered it too. “During the grunge period, there was also these other types of music in at the bottom… the heavier stuff, like extreme metal, started to grow as well.”

Grunge reacted against polished pop; extreme metal reacted against grunge. “They were still popping around,” she said, “and what they started back then developed, and we got all this metal just coming from the underground.”

We talked about Pantera’s Reinventing the Steel and Judas Priest’s return with Angel of Retribution. Liv lit up: “Angel of Retribution, yeah, yeah.” I told her Halford seemed possessed, like he was saying, “We’re gonna school you motherfuckers, and this is… we created metal.” Liv nodded. “He’s the metal god… one of the idols that I’ve had and looked up to… also as a stage person.”

I mentioned how Halford has a little Elvis in him, a little Liberace, a little Freddie Mercury — how every great performer steals from everywhere. Then I asked her what she’d woven into her own performance DNA. She said, “First of all, Dee Snider definitely… his stage presence always blew my mind… he’s on stage for the audience. He’s an entertainer.” She named Angela Gossow: “How she just takes the stage… she’s born with it.” And Sebastian Bach: “He also has a lot of energy on stage.” She admitted, “Absolutely I’ve stolen some parts from them… or got inspired, maybe.”

I talked about Jeff Beck, about Lemmy’s generosity, about bandleaders who know everything happening onstage. Liv explained how Liv Sin uses cues. “We have some cues in some of the songs… I know I can go back and then we know that someone will go forward…sometimes it’s a guitar solo, sometimes a bass move.

“It’s not very staged… could be two, could be one, could be three… then I move very freely.”

Her priority is always the audience. “Sometimes I can get into the audience and I can miss my band members… oops, there was a guitar player or my hair gets stuck in the bass.” She laughed. “We headbang a lot, and yes, it sucks a lot. It gets stuck.”

I asked her what it was like working with Lemmy, and she corrected me gently. “I have not worked with Lemmy. I’ve only played support.” Sister Sin supported Motörhead for two shows. “I’m very happy that I got the opportunity.”

She talked about doing a Motörhead cover with Doro — “Lemmy was not involved… we asked Doro if she wanted to join in, and she wanted to do that.”

When I asked about memorable bands she’d performed with, she didn’t hesitate. “Obviously Motörhead,” she said. “It was such a huge thing.” She also loved touring with Udo. “They’re really nice people… we had a lot of fun with them… still talk to the guys from time to time…it’s not with every main band you get that kind of feeling,” she said, “but we really had fun together.”

I told her a story about Oslo — Madder Mortem, Gorgoroth, Emperor, Red Harvest, Faust — and a Swedish girl face‑planting drunk at three in the morning. I asked if Scandinavia had a drinking problem. Liv answered with clarity. “I’m not sure it’s more than in any other countries… but in the Scandinavian countries we have more of a tradition of only drinking on weekends. People squeeze everything into Friday and Saturday. Everything is cold and boring, and you work weekdays, and then the weekend comes, and then you try to squeeze in all the alcohol you can.” She added that younger generations drink less now.

Then we got into the heart of it — the difference between Sister Sin and Liv Sin. Liv explained it plainly. “Sister Sin is obviously more rock and roll… the roots are from Motörhead… some punk rock… but it’s more like rock and roll with a bit of metal in it.” She talked about reunion shows with Accept, balancing schedules, her long history with the members. “They’re great songwriters.”

When Sister Sin quit in 2015, she was devastated. But she also felt an urge not to give up. “If I’m gonna do my own band, what is the music I desire to do?” she asked herself. “It is more metal because I’m more of a metalhead than a rock and roll girl.” She loves heavy riffs, double‑bass drums, juicy production, synths. “You can’t have that in Sister Sin… it doesn’t work with that kind of music.”

So she started Liv Sin — and started exploring her voice. “I started to learn how to growl… I found that I love doing that.” She also learned she could sing softly. “I was like, I can never sing soft… I can never growl… and I’ve realized I can sing soft and I can growl.” She built a bedroom studio, experimented with production, tried everything — soft singing, growling, screams. “I found out that I could do things that I didn’t think I could do.”

The collapse of Sister Sin became a catalyst. “I was devastated,” she said. “But now I’m happy that it happened… it gave me the opportunity to develop and find my own voice.” Now, when she returns to Sister Sin, she brings that confidence with her. “I write my own music… I write my lyrics… I write my melodies… I can do whatever I want… and that is empowering.”

And then came the part that matters deeply to her — the animals.

Liv didn’t just mention animal rights; she opened a vein. She told me she’d been vegetarian since birth. “I grew up with animals,” she said. “Cats, birds… animals were always around me.” She talked about how natural it felt, how she never had the moment of “deciding” to care — she simply always did.

Then she told me about Cecil the lion.

“When Cecil was killed,” she said, “I was so angry. I was devastated.” That anger became “King of the Damned.” “We used it to raise funds for animal rights,” she said. She talked about Djurrätt, the Swedish organization she supports. She talked about how the song became a way to channel grief into action.

She told me, “I can relate more to animals sometimes. It’s easier to trust them.” And she meant it. There was no performative activism in her voice — only conviction.

I mentioned Napalm Death and Carcass being vocal about anti‑vivisection. “I admire bands who use their platform,” she said. “Music can make people aware. It can make people think.” She talked about how Liv Sin’s fans have supported her activism, how they’ve shown up not just for the music but for the message.

She talked about compassion as rebellion — a radical stance in a world that rewards cruelty. She talked about how metal, at its best, has always been a refuge for people who feel too much.

We talked about Eastern philosophy — her mother teaching yoga and religion, her childhood spent in temples, mosques, churches. She explained Kali Yuga, the chaotic age in Hindu cosmology. “It’s the worst period,” she said, “and we are still in it.” Writing helps her process the overwhelm of witnessing a world in collapse.

As we wound down, Liv outlined her future plans — festivals in Sweden and France, weekend shows, a support tour with Elaine, and writing a new Liv Sin album after the fall tour. She expressed gratitude to her fans. “Thanks to our very supportive fans, we are still here.”

I presented her with a Pawsie Award for cultural achievement and humanitarian effort. She smiled and flashed the Pawsie sign.

(Thanks to Lee Bailes for the interview transcription.)

Alex S Johnson’s 30+ year history as an author, journalist, editor, spoken word performer and educator includes work archived at Harvard University’s “mega-library,” the Widener, collaborations and performances with the likes of Iris Berry (Lame Flames, Pink Sabbath, the Ringling Sisters with Pleasant Gehman, Border Radio with John Doe; Punk Hostage Press); Richard Modiano (Emeritus Executive Director of Beyond Baroque literary arts center, Venice Beach, California, which has hosted the likes of Dennis Cooper, Patti Smith, Exene Cervenka, Iris Berry, Pleasant Gehman, and Alex S Johnson); David J. Haskins (Songwriter of “Bela Lugosi’s Dead”; co-founder of Bauhaus and Love and Rockets); Ellyn Maybe (author of The Cowardice of Amnesia and praised by the likes of Jackson Browne and Greil Marcus) and Lasara Firefox Allen, bestselling author of Sexy Witch and Jailbreaking the Goddess). He has also interviewed the likes of Ronnie James Dio of Black Sabbath, Lemmy Kilmister of Motorhead, counterculture icons like Gitane Demone, Rozz Williams, R.U. Sirius, Jarboe, Diamanda Galas and Danielle Willis. He lives in Carmichael, California with his family. 

A Government Trying to Rebuild a Reading Habit, One Grant at a Time

I keep thinking about a small detail buried in a government decree from January of this year: Uzbekistan is now requiring workplaces to set up a physical “book corner” and run a monthly “reading hour” for employees. Not schools — workplaces. Offices, factories, ministries. There’s even an internal ranking system tracking who reads the most, with a cash prize equal to a month’s salary for the top reader.

There’s something almost touching about the specificity of it, and also something a little sad. You don’t legislate a “reading hour” into existence unless the habit has genuinely eroded and someone in government noticed and decided it mattered enough to write into law.

Uzbekistan has spent the better part of a decade trying to rebuild its publishing ecosystem and its reading culture more or less from the ground up, and the newest round of measures, formalized this January, gives a pretty clear picture of where the pressure points are.

The most direct intervention is aimed at people who actually write books. Young writers can now apply for competitive grants that cover, for up to a year, a monthly stipend worth fifty times the base calculation unit — enough, in local terms, to let someone write without a second job eating all their hours. On the translation side, the government will cover half the production costs and eighty percent of the copyright costs for translating major foreign literature into Uzbek, and for translating Uzbek literature outward into other languages. That second half matters more than it might look at first glance. A national literature that only gets read domestically stays provincial almost by definition; a translation subsidy is, in a quiet way, an attempt to put Uzbek writers into conversation with the rest of the world’s readers rather than leaving them talking only to each other.

There’s also a slower, more structural piece: every year, at least three professional and technical books from abroad are supposed to get translated into Uzbek by local publishers, annotated with glossaries and explanatory notes by qualified specialists. It’s an unglamorous kind of literary infrastructure — nobody’s writing poems about a translated engineering textbook — but it’s the sort of thing that determines whether a country’s professionals can actually work from up-to-date knowledge in their own language, or whether they’re permanently a few years behind because the good material only exists in English.

None of this happens in a vacuum. It builds on a longer push that started with something more physical: getting book-selling spaces into towns and cities that didn’t have any. Regional governments were told, back in earlier rounds of this policy, to hand over unused state-owned buildings, rent-free, to anyone willing to open a specialized bookstore. Shops that did more than seventy percent of their business in books got a tax exemption. That’s the kind of policy that doesn’t generate headlines but quietly changes whether a teenager in a smaller regional town has anywhere at all to buy a novel.

The most recent presidential address added a number that stuck with me: ten million books a year are meant to be distributed to school libraries, framed explicitly as an effort to get young people in local neighborhoods reading again. There’s also a longer-range plan running through 2030 to digitize library collections entirely, so that physical distance from a major city library stops being the reason someone can’t get access to a book.

I don’t think any of this guarantees a reading renaissance. You can subsidize book prices and still lose to a phone screen; you can build a library and still find it empty. Reading habits are shaped by a hundred things a ministry can’t legislate — what your parents read to you, whether your friends talk about books, whether you’re too exhausted after work to open one. A mandated “reading hour” at the office might produce a genuine habit in some people and pure performance in others, and there’s no easy way from the outside to tell which is happening.

But I find myself less cynical about this than I expected to be, mostly because of where the money is actually going. It’s not vanity publishing for state-approved narratives — it’s stipends for young writers to have time to write, and subsidies specifically for bringing outside literature in and sending local literature out. That’s a bet on literature as exchange rather than literature as propaganda, which is a distinction worth noticing, especially from a government that could have chosen the easier, more self-serving version of a “reading culture” campaign.

Whether it works is a ten-year question, not a one-year one. But it’s rare to see a state put actual line items — fifty times the base unit here, eighty percent of copyright costs there — behind something as soft-sounding as “getting people to read more.” I’ll take that as a more honest starting point than most cultural policy manages.

Amonboyeva Shahnoza, student of Urgench State University, working towards a bachelor’s in computer engineering

The Future

The past slips through our fingers like sand;

it does not return, no matter how we call it back.

The present is the only thing we truly have,

and within it, tomorrow is born.

We do not know what is coming,

but we know what we can wish for:

goodness for every human being,

peace for every child, a life without fear.

To be human is not easy,

and to be good is even harder.

Yet that is what we are called to be.

There is one planet,

and there is room for all.

Not to divide, but to recognize one another.

A world without wars,

without hunger and tears,

without the blood of the innocent —

is not a dream, but a choice.

If we pause and listen to ourselves,

we will hear a quiet voice: love.

In that word, change begins.

We must change ourselves

to change the world.

We must be the light when everything

seems on the verge of breaking.

Children are watching us.

What will we leave them?

The future is not something we wait for —

it is something we create.

Together.

Tanja Ajtic was born in Belgrade, Serbia. She lived and studied in Serbia. She is a poet and writer but she is also an artist. She also deals with fine graphics. Since 2002, she lives and creates in Canada. Moved to Belgrade, Serbia 2023. Tanja Ajtic is a member of many groups and associations. In Serbia, she is a member of the prestigious Society of Writers of Belgrade. Her poems and stories have been published two hundred collections (books), anthologies and electronic books. Her poems have been published in twelve languages. She published her book Outlines of Love. She participated with books and anthologies at many fairs in the world with other authors. In 2024 and 2025, Ajtic collaborated with Indian poet Sourav Sarkar on two joint poetry collections that present two works by the poet in one book. – She won second prize in Great Britain from the Serbian Library in London (2019). – She won III World Prize for Excellence: Cesar Vallejo; 2021 in the category of artistic excellence Lima, Peru, by the World Spanish Union of Writers and International Award of Excellence; from the World Spanish Union of Writers, UHE Mexico. –

She won the I International Award of Excellence & “Cita Del Glateo” Antonio De Ferrariis, IX edition 2022 – Rome, Italy, a prestigious award in the group of poets for the English language (IX edition of the award for foreign poetry in English) in 2022, Rome, Italy. – Winners of Foundation Naji Naaman literary prize iz 2023; (21 st Edition), from the Republic of Lebanon, Honor Prize (for complete work) for Literary prizes 2023. Poetry for the competition was submitted in three languages: English, French and Arabic. – Winning the 2023 “Zheng Nian Cup” Literary Award – Third Prize by the Beijing Mindfulness Literature Museum, China. – Winning Third Prize, Friedrich Schiller International Literary Competition (2025). She is the winner of many awards, diplomas and certificate. She is currently writing poetry, short stories, haiku, Gogyoshi poetry as well as graphics artist as a freelance artist.

While Looking at Jennifer Lopez’s Photo

–

Your photo in underwear

Affects the human subconscious.

Your body is like an ancient hourglass,

And you are a modern lady.

Time itself grows old, but you do not.

–

Your body is like an hourglass,

And perhaps because of this,

You have as many admirers as grains of sand.

–

Your body is like an hourglass.

The wristwatches of those who are in love with you

Check their pulses like doctors.

They have found heart pain.

–

Your body is like an hourglass,

And

Wall clocks have grown old.

Now the hands of those clocks

Are like old people walking on three legs.

–

And

You, on two legs, are both

The most beautiful woman in this world

And the most beautiful in heaven.

–

You are also like wine.

As the years pass, your quality increases,

And you drive people out of their minds.

–

But your voice

Is melodious like the sound of a clock.

In what pleasant hour

Of God’s good mood did you come into this world?

–

This is the most beautiful poem

Written for you.

Save its author

From this hell.

CERVICAL CANCER: EARLY DETECTION AND MODERN PREVENTION

Kamolabonu Rasuljon qizi Inomova

6th-year student, Faculty of General Medicine, Andijan State Medical Institute

ORCID: 0009-0005-4285-4578

ABSTRACT

Cervical cancer is one of the most common malignancies among women, and persistent infection with high-risk human papillomavirus (HPV) is the principal etiological factor in its development. A defining feature of the disease is that it is preceded by a precancerous stage, meaning that invasive cancer does not develop suddenly. Consequently, cervical cancer can be substantially prevented through HPV vaccination, screening, and timely treatment of precancerous lesions. This article reviews current epidemiological indicators of cervical cancer, the pathogenetic role of HPV infection, and the clinical significance of HPV vaccination, HPV-DNA-based screening, genotyping, and individual risk assessment. According to GLOBOCAN 2022, 662,301 new cases of cervical cancer and 348,874 deaths were recorded worldwide. A modern prevention strategy integrates HPV vaccination, high-performance screening, risk stratification of HPV-positive results, and timely treatment of detected precancerous changes into a single continuum of care. In conclusion, reducing the burden of cervical cancer requires strengthening an uninterrupted system of prevention and early diagnosis.

Keywords: cervical cancer, HPV, human papillomavirus, screening, HPV-DNA, vaccination, genotyping, CIN, precancerous lesions, gynecologic oncology.

INTRODUCTION

Cervical cancer remains one of the major medical and social problems affecting women’s health. According to the World Health Organization (WHO), approximately 660,000 women worldwide were diagnosed with cervical cancer in 2022, and nearly 350,000 women died of the disease. Cervical cancer is among the most common cancers in women, ranking fourth among female cancers worldwide according to the WHO [1,2].

According to the IARC Global Cancer Observatory, 662,301 new cases and 348,874 deaths from cervical cancer were recorded in 2022. The age-standardized incidence rate was 14.1 per 100,000 women, and the age-standardized mortality rate was 7.1 per 100,000 [3].

Nearly all cases of cervical cancer are associated with high-risk HPV infection. According to the WHO, approximately 99% of cervical cancer cases are linked to high-risk HPV [1].

An important feature of this disease is that precancerous changes develop in the cervical epithelium before an invasive tumor forms. Detecting and appropriately treating the disease at this stage can prevent progression to invasive cancer. HPV vaccination and screening are therefore the cornerstones of modern prevention.

The aim of this review is to analyze current approaches to the prevention and early detection of cervical cancer, in particular HPV vaccination, HPV-DNA-based screening, and individual risk assessment through HPV genotyping.

MATERIALS AND METHODS

This article was prepared as a narrative scientific review. WHO and IARC documents, together with contemporary scientific literature on cervical cancer epidemiology, HPV infection, vaccination, screening, and HPV genotyping, were analyzed.

Primary attention was given to international clinical recommendations, epidemiological data, and recent meta-analyses. Epidemiological indicators were assessed using GLOBOCAN 2022 data, while screening and HPV genotyping recommendations were evaluated against current WHO guidance documents [3–6].

RESULTS AND DISCUSSION

The role of HPV infection in cervical cancer

HPV is a widespread group of viruses, certain genotypes of which carry high oncogenic risk. HPV-16 and HPV-18 in particular are strongly associated with cervical cancer [1,2].

HPV infection does not always lead to cancer. Most infections are controlled by the immune system and resolve spontaneously. However, if high-risk HPV infection persists, cervical intraepithelial neoplasia may develop [1].

This pathological process can be summarized schematically as follows:

High-risk HPV infection → persistent infection → cervical intraepithelial neoplasia (CIN) → high-grade precancerous changes → invasive cancer.

Table 1. Key epidemiological indicators of cervical cancer, 2022

Indicator	Value
New cases	662,301
Deaths	348,874
Age-standardized incidence rate	14.1 per 100,000
Age-standardized mortality rate	7.1 per 100,000

Source: IARC Global Cancer Observatory, GLOBOCAN 2022 [3].

HPV vaccination

HPV vaccination is one of the most important tools of primary prevention for cervical cancer. The WHO identifies girls aged 9–14 as the primary target group for HPV vaccination. Vaccination before HPV exposure provides the greatest preventive benefit [4].

A large cohort study demonstrating the clinical effectiveness of HPV vaccination followed 1,672,983 girls and women aged 10–30 years in Sweden. The study found that HPV vaccination was associated with a significant reduction in the risk of invasive cervical cancer, with the protective effect being greatest among those vaccinated before age 17 [5].

However, HPV vaccination does not eliminate the need for screening. Screening in accordance with national recommendations must continue even after vaccination.

HPV-based screening

For many years, the Pap test was the principal cytological screening method for the prevention of cervical cancer. High-risk HPV-DNA testing has since become a major primary screening method owing to its high sensitivity.

The WHO recommends HPV-DNA-based testing as the preferred method for primary cervical cancer screening. The starting age and screening interval depend on the national program; the WHO’s 2021 recommendations describe strategies using HPV-DNA testing from age 30, with a 5–10-year interval [6].

A systematic review and meta-analysis published in 2026 analyzed data from 8 studies involving 414,846 participants. HPV-based screening detected CIN2+ lesions at a 61% higher rate than cytology (RR 1.61; 95% CI 1.30–1.98). The authors emphasized the need for risk stratification to appropriately manage HPV-positive patients and to avoid overdiagnosis and overtreatment [7].

Table 2. Comparison of cervical cancer screening methods

Method	What it detects	Advantage	Limitation
Pap test	Cytological changes	Extensive clinical experience	Potential for subjective interpretation
HPV-DNA test	High-risk HPV	High sensitivity	A positive result does not indicate cancer is present
HPV genotyping	Specific HPV genotypes	Individual risk assessment	Requires specialized laboratory capacity
Self-sampling	HPV	Can expand screening coverage	Requires follow-up after a positive result

HPV genotyping and individual risk assessment

Modern screening strategy is not limited to determining whether HPV is present. Equally important is assessing, among HPV-positive women, the risk of developing clinically significant precancerous changes.

On 8 May 2026, the WHO issued an updated guideline on HPV-DNA genotyping. It describes three approaches to HPV genotyping — no genotyping, partial genotyping, and extended genotyping — and their role in risk stratification and molecular triage [8].

This approach can be represented through the following algorithm:

HPV-DNA test → genotyping → risk stratification → triage → colposcopy/biopsy → treatment or follow-up.

The purpose of this strategy is not to examine all HPV-positive women with the same intensity, but to more rapidly identify clinically high-risk groups and provide them with priority diagnostic and treatment support.

The WHO’s 2026 recommendations note that the choice of genotyping strategy must take into account laboratory capacity, availability of follow-up and treatment services, and the resources and capabilities of the health system [8].

The WHO 90–70–90 strategy

To eliminate cervical cancer as a public health problem, the WHO has established the 90–70–90 global targets [9].

Table 3. WHO 90–70–90 global targets

Domain	Target
HPV vaccination	≥90% of girls fully vaccinated by age 15
Screening	≥70% of women screened with a high-performance test by ages 35 and 45
Treatment	≥90% of women with identified cervical disease appropriately managed

The essence of this strategy is to unite all stages of prevention into a single system: strengthening primary prevention through HPV vaccination, detecting precancerous changes through high-performance screening, and providing timely treatment of identified disease.

The WHO has defined the elimination threshold for cervical cancer as fewer than 4 new cases per 100,000 women per year [9].

Self-sampling and digital technologies

HPV self-sampling — in which a woman collects her own specimen for HPV testing — can expand access to screening services. This approach may be particularly important for women with limited access to healthcare or those who are less engaged with conventional screening.

However, the effectiveness of self-sampling is not determined by specimen collection alone. Triage, colposcopy, and appropriate treatment must also be available following a positive HPV result.

Digital medicine and artificial intelligence are also promising directions in gynecologic oncology. They may be used to analyze colposcopic images, digitize cytological material, monitor patients, and support clinical decision-making. However, before such technologies are introduced into clinical practice, their diagnostic accuracy, validation across diverse populations, and patient data privacy must be evaluated.

PRACTICAL RELEVANCE FOR UZBEKISTAN

International strategies for the prevention of cervical cancer are also of practical relevance to the healthcare system of Uzbekistan.

To improve the effectiveness of prevention, it is important to engage women in screening at the primary healthcare level, raise public health literacy regarding HPV and its prevention, refer patients with positive results to further diagnostic stages, and build an uninterrupted system through to treatment.

Family physicians can play an important role at the primary healthcare level in identifying at-risk groups, referring patients for screening, and ensuring follow-up of patients with positive screening results.

At the same time, in improving screening programs in Uzbekistan, it is important to adapt international recommendations to the local epidemiological situation, laboratory capacity, medical infrastructure, and available resources.

CONCLUSION

Cervical cancer is one of the oncological diseases with the greatest potential for prevention. Persistent high-risk HPV infection is the principal etiological factor in its development, a feature that makes it possible to control the disease through primary and secondary prevention.

HPV vaccination is a key component of primary prevention, while HPV-DNA-based screening is a key component of secondary prevention. Modern HPV genotyping technologies make it possible to stratify HPV-positive women by individual risk level and to improve clinical management.

An effective prevention system should be built on the following sequence:

HPV vaccination → HPV-DNA-based screening → risk stratification → triage → colposcopy and biopsy where indicated → treatment of precancerous lesions → follow-up.

Thus, integrating prevention, early detection, and individualized risk-based clinical management into a single system remains one of the most promising strategies for reducing the global burden of cervical cancer.

REFERENCES

1. World Health Organization. Cervical cancer [Internet]. Geneva: World Health Organization; 2026 [cited 2026 Sep 14].

2. World Health Organization. Human papillomavirus and cancer [Internet]. Geneva: World Health Organization; 2024 [cited 2026 Sep 14].

3. International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today. Cervix uteri. Lyon: IARC; 2024.

4. World Health Organization. Human papillomavirus vaccines: WHO position paper, December 2022. Wkly Epidemiol Rec. 2022;97(50):645-672.

5. Lei J, Ploner A, Elfström KM, Wang J, Roth A, Fang F, et al. HPV vaccination and the risk of invasive cervical cancer. N Engl J Med. 2020;383(14):1340-1348. doi:10.1056/NEJMoa1917338.

6. World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. 2nd ed. Geneva: World Health Organization; 2021.

7. da Rocha KC, Castanha EB, Elias MEM, da Silva CML. Human papillomavirus-based vs. cytology for cervical cancer screening: a systematic review with meta-analysis. Rev Bras Ginecol Obstet. 2026;48:e-rbgo130. doi:10.61622/rbgo/2026rbgo130.

8. World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention: use of human papillomavirus (HPV) DNA genotyping. Geneva: World Health Organization; 2026.

9. World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: World Health Organization; 2020.

10. Ronco G, Dillner J, Elfström KM, Tunesi S, Snijders PJF, Arbyn M, et al. Efficacy of HPV-based screening for preventing invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014;383(9916):524-532.

11. Sankaranarayanan R, Nene BM, Shastri SS, Jayant K, Muwonge R, Budukh AM, et al. HPV screening for cervical cancer in rural India. N Engl J Med. 2009;360(14):1385-1394.

12. Joura EA, Giuliano AR, Iversen OE, Bouchard C, Mao C, Mehlsen J, et al. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N Engl J Med. 2015;372(8):711-723.

13. Mayrand MH, Duarte-Franco E, Rodrigues I, Walter SD, Hanley J, Ferenczy A, et al. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. N Engl J Med. 2007;357(16):1579-1588.

14. World Health Organization. Evidence-informed guidance for the implementation of HPV-based cervical cancer screening programmes. Geneva: World Health Organization; 2026.

And we drink vodka

People yoked in the field until old age

Like buffalo

Like horses

Instead of buffalo

Instead of horses

Harder than being a buffalo

Harder than being a horse

Tilling the soil is like digging a hole for their own coffin

People yoked in someone else’s field in their own village

Here in this field the villagers get their own death instead of fruit

Century after century

Serfdom

Stone by stone

They say that the whites exploited the blacks, forcing them to work until exhaustion and death

They say that the blacks were slaves in the hands of foreign white rulers

But what is it like to be a peasant and a slave in the hands of your own rulers

White peasant serfs put to work for other white people who pretend that they are not serfs and not peasants

Century after century

Serfdom

Stone by stone

What is night? This is the time when you can steal the harvest from your own field secretly while the owner is not looking

Owners generally do not see many things

At that time, blind peasants work and twice-blind soldiers die

But the peasants, still harnessed to the yoke, dug like madmen

A coffin? A ditch? No, they dug carrots, potatoes, collected wheat and oats, and along with them they got diseases and death

And what could naked, hungry peasants do against people with machine guns and smiles made of knives?

Century after century

Serfdom

Stone by stone

This is a vicious circle

This is a circle that even Dante couldn’t get to

This wheat grew on the bones of someone’s grandmothers

This oats are soaked in the blood of someone’s grandfathers

The future has the wrong door

The future hasn’t come

This wheat grew instead of someone’s hair

This oats ripened instead of someone’s blush

Century after century

Serfdom

Stone by stone

And we, half-drunk, with friends, vomit standing on this field

We spit out pieces of undigested food

And we drink until we forget because we can’t help but drink

And we die because we can’t help but die

ISMS’ END: THE PROMISE OF PROGENY

We are all here, nerves and graves,

we, the todays and yesterdays.

The path of song runs through everyone. 

The Olympic pool doubles the sun

while the winter moon halves it.

Humanity lives in its huts

with its gods and with its isms

(and every belief system is an ism–

but why are there no isms of innocence?).

Humanity divides its world with walls and fences.

How permanent! yet how delicate!

are these stews in our kettles’ bellies!

Today’s chefs, prepare your tools and kitchens,

lay out your dynastic friction.

Those urns, those ferns, those burns

— those tomorrows—those blurs–

they still await their turn.

And they hope to mature.

And they hope to endure.

But we hope they can sing us to better futures.

Lacking the doneness of death,

living has a possibility yet.

ST. GEORGE’S DILEMMA

I am a knight,

a man in tin

upon a mission.

I have a dragon

Inside,

and there’s a maiden

Within,

and I must decide

which I should save

and which must slay.

SHEET MUSIC

When we concerto alone

you hum pianissimo

until my baton is down.

ANGELS’ ALLIES

Chicago exorcists of the curse of Hue,

the children’s choice seemed so simple and so clear: 

To purge and burn the stench of their parents’ sins

as voyeurs in Johnson/Nixon’s daisy chain.

Even as torrents of TV blood and horror

entombed the country’s slumbering shame and guilt

beneath accumulations of mud and silt,

they nurtured the nations’ worst hotel murders.

“So, whose side are you on?” A binary pick —

The side of the assassins or the martyrs.

And which will you be, the muck or the water?

Heedless moral passion or cowardly check?

Dump the Hump! Make Love Not War! Get Clean For Gene!

 Tune In, Drop Out! Trust No One Over 30!

New! Improved! Eliminate Parental Dirt!

Alas. We knew not the problem’s in our genes.

I ASK US

At which When did we become our parents,

self-convinced once more of our own invincibility’s

blood, bones, and blues?

There’s a border, we thought, between those anxious 

actions of the bulls on the street

and the bulls of the freight;

so at what Then did the line get crossed?

On some cryptic boiling point

our former arrogant innocence transmuted to ignorant inerrancy.

And, unappalled, we applaud our Light’s sad

transformation into Lightning Bolts.

So to Fate’s position we default.

But, in our prescient prehistoric youth, were’nt we

Already angels’ allies?