Objectives; How to eliminate cervico-vaginal cancer in Japan. Session time; 60 mins. Cervical cancer incidence has been rising since the late 1990s to 11 per 100,000 women, and this rise is particularly prominent in women of reproductive age in Japan. While the recent resumption of the active recommendations of HPV vaccine was a critical step forward, there are still unresolved issues and fundamental challenges in monitoring and achieving the global targets. Dr. Rei Haruyama aims to synthesize these issues and provide considerations for enhancement of cervical cancer control in Japan. Dr. Tomomi Nakahara investigated mechanisms for HPV genome replication and maintenance in HPV life cycle. She identified that HPV genome can be maintained in an E1, a viral DNA helicase, independent manner in basal cells of the stratified epithelium by using a tissue culture model to recapitulate HPV life cycle. She will discuss how these findings could be exploited to develop a new therapy to eliminate the viral persistence and prevent cervical cancer. Dr. Kaori Okayama developed a system to identify 39 HPV types including all high-risk (HR), all possibly high-risk (pHR), and some low-risk (LR) HPV types using molecular mapping or a single cell sorting procedure. HPV genotyping using cervical or vaginal cell samples reveals that HR-HPV types are predominantly in the uterine cervix, LR-types in the vagina, and pHR types equally in both sites. Tissue tropisms in different HPV-risk types may help us to understand HPV carcinogenesis in the cervico-vagina, providing useful information in clinico-pathological diagnosis.