ArticleInternational journal of cancer2025
Colposcopy referrals and CIN3 detection after triage by host cell DNA methylation and/or HPV genotyping in HPV positive women with low-grade cytology from a population-based Dutch primary HPV screening trial.
Article in International journal of cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- PAX1 methylation for triage of HR-HPV-positive women: a comparative analysis with cytology and HPV16/18 genotyping.BMC cancer · 2026Article
- Predicting optimal impact interventions in the post-HPV vaccination world.International journal of cancer · 2026Review
- DNA Methylation in Cervical Intraepithelial Neoplasia and Cervical Cancer: Triage and Management.Current topics in microbiology and immunology · 2026Review
- The cost-saving impact of human papillomavirus self-sampling for cervical cancer screening in women workers at the manufacturing sector in Ciudad Juárez, Chihuahua, Mexico.PLOS global public health · 2026Article
- Evaluating the Predictive Performance of miR-124-2 and FAM19A4 for Cervical Lesions in a Single Center from Romania: A Prospective Study.Journal of clinical medicine · 2025Article
- The Role of HPV Genotyping, Cytology, and Methylation in the Triage of High-Risk HPV-Positive Patients.Biomedicines · 2025Article
- Colposcopy referrals and CIN3 detection after triage by host cell DNA methylation and/or HPV genotyping in HPV positive women with low-grade cytology from a population-based Dutch primary HPV screening trial.International journal of cancer · 2025Article
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13 authors.
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Abstract
High-risk HPV (hrHPV)-based screening has led to many unnecessary colposcopy referrals, mainly because of direct referral after low-grade cytology (ASC-US/LSIL). DNA methylation and genotyping tests on ASC-US/LSIL samples have the potential to significantly improve the efficiency of screening. In this study, 12 triage strategies were constructed from FAM19A4/miR124-2 or ASCL1/LHX8 methylation, HPV16/18 or HPV16/18/31/33/45 genotyping and 1-year repeat cytology. The performance was evaluated on 215 hrHPV-positive ASC-US/LSIL samples from the IMPROVE trial (NTR5078). Performance was measured by colposcopy referral rate, positive predictive value (PPV) for detecting precancer (CIN3), and negative predictive value (NPV). To evaluate efficiency, strategies were ordered by the cumulative colposcopy referral rate after 1-year cytology and compared by the marginal PPV to detect one additional CIN3 (mPPV). The most conservative strategy (referral when HPV16/18 and FAM19A4/miR124 methylation results are positive) had a direct referral rate of 5.2%, a cumulative referral rate after 1-year cytology of 54.1%, and mPPV of 19.3%. Replacing HPV16/18 by HPV16/18/31/33/45 increased the cumulative 1-year referral rate to 54.6%, and yielded an mPPV of 10.0%. Similar results were obtained for strategies with ASCL1/LHX8 methylation. Of all strategies, referral after an HPV16/18/31/33/45 positive, ASCL1/LHX8 methylation-positive, and/or 1-year cytology-positive result yielded the highest direct and cumulative 1-year colposcopy referral rates of 64.4% and 79.1%, respectively. The NPVs after 1-year cytology varied between 98.1% and 99.4%, warranting a return to routine screening. Altogether, DNA methylation-based triage strategies are recommended as they are discriminative for CIN3 and control the number of immediate colposcopy referrals.
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