Evidence map›Paper›PMID 40106366›Full record

ArticleJMIR public health and surveillance2025

Identifying Data-Driven Clinical Subgroups for Cervical Cancer Prevention With Machine Learning: Population-Based, External, and Diagnostic Validation Study.

Zhen Lu, Binhua Dong, Hongning Cai, Tian Tian, Junfeng Wang, Leiwen Fu, Bingyi Wang, Weijie Zhang, Shaomei Lin, Xunyuan Tuo and 9 more

Abstract readValidation Study
In one paragraph

Article in JMIR public health and surveillance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Zhen LuSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.ORCID 0000-0002-3481-6310
Binhua DongDepartment of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.ORCID 0000-0002-5086-0696
Hongning CaiDepartment of Gynecology, Maternal and Child Health Hospital of Hubei Province (Women and Children's Hospital of Hubei Province) Wuhan, Wuhan, China.ORCID 0000-0002-4700-2754
Tian TianSchool of Public Health, Xinjiang Medical University, Urumqi, China.ORCID 0000-0002-6103-1666
Junfeng WangDivision of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands.ORCID 0000-0001-5157-5355
Leiwen FuBeijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.ORCID 0000-0003-3959-5788
Bingyi WangInstitute for HIV/AIDS Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.ORCID 0000-0002-3713-0488
Weijie ZhangSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.ORCID 0009-0003-0582-5255
Shaomei LinDepartment of Gynecology, Shunde Women's and Children's Hospital of Guangdong Medical University, Foshan, China.ORCID 0009-0008-4496-043X
Xunyuan TuoDepartment of Gynecology, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, China.ORCID 0009-0003-2802-3650
Juntao WangDepartment of Gynecology, Guiyang Maternal and Child Health Care Hospital, Guiyang, China.ORCID 0000-0001-6097-9079
Tianjie YangDepartment of Gynecology, Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China.ORCID 0009-0001-9970-6788
Xinxin HuangThe Ministry of Health, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.ORCID 0000-0002-3611-3061
Zheng ZhengDepartment of Gynecology, Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China.ORCID 0009-0002-7609-7032
Huifeng XueCenter for Cervical Disease Diagnosis and Treatment, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.ORCID 0000-0001-8338-0296
Shuxia XuDepartment of Pathology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.ORCID 0000-0001-8163-9145
Siyang LiuSchool of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.ORCID 0000-0001-6780-9419
Pengming SunDepartment of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.ORCID 0000-0002-5072-6091
Huachun ZouSchool of Public Health, Fudan University, Shanghai, China.ORCID 0000-0002-8161-7576

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Cervical cancer remains a major global health issue. Personalized, data-driven cervical cancer prevention (CCP) strategies tailored to phenotypic profiles may improve prevention and reduce disease burden. Objective: This study aimed to identify subgroups with differential cervical precancer or cancer risks using machine learning, validate subgroup predictions across datasets, and propose a computational phenomapping strategy to enhance global CCP efforts. Methods: We explored the data-driven CCP subgroups by applying unsupervised machine learning to a deeply phenotyped, population-based discovery cohort. We extracted CCP-specific risks of cervical intraepithelial neoplasia (CIN) and cervical cancer through weighted logistic regression analyses providing odds ratio (OR) estimates and 95% CIs. We trained a supervised machine learning model and developed pathways to classify individuals before evaluating its diagnostic validity and usability on an external cohort. Results: This study included 551,934 women (median age, 49 years) in the discovery cohort and 47,130 women (median age, 37 years) in the external cohort. Phenotyping identified 5 CCP subgroups, with CCP4 showing the highest carcinoma prevalence. CCP2-4 had significantly higher risks of CIN2+ (CCP2: OR 2.07 [95% CI: 2.03-2.12], CCP3: 3.88 [3.78-3.97], and CCP4: 4.47 [4.33-4.63]) and CIN3+ (CCP2: 2.10 [2.05-2.14], CCP3: 3.92 [3.82-4.02], and CCP4: 4.45 [4.31-4.61]) compared to CCP1 (P<.001), consistent with the direction of results observed in the external cohort. The proposed triple strategy was validated as clinically relevant, prioritizing high-risk subgroups (CCP3-4) for colposcopies and scaling human papillomavirus screening for CCP1-2. Conclusions: This study underscores the potential of leveraging machine learning algorithms and large-scale routine electronic health records to enhance CCP strategies. By identifying key determinants of CIN2+/CIN3+ risk and classifying 5 distinct subgroups, our study provides a robust, data-driven foundation for the proposed triple strategy. This approach prioritizes tailored prevention efforts for subgroups with varying risks, offering a novel and scalable tool to complement existing cervical cancer screening guidelines. Future work should focus on independent external and prospective validation to maximize the global impact of this strategy.

Indexed as

Machine LearningUterine Cervical NeoplasmsAdultCohort StudiesFemaleHumansMiddle AgedUterine Cervical Dysplasiaalgorithmcancercancer preventioncarcinomacervical cancercervical tumorEHRelectronic health recordhuman papillomaviruslogistic regressionmachine learningmalignantMLphenomapping strategypopulation-basedregressionscreeningsurveillancetumorusabilityvalidation studyvalidity

Identifiers

PMID40106366
PMCPMC11939026

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.