ArticleBMC cancer2025
Clinical performance of triage strategies for HPV-positive women in cervical cancer screening in rural Yunnan China.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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.
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Who cites it
4 citing papers in PubMed.
- Additional Diagnostic Yield of Endocervical Curettage in Type 3 Transformation Zone for High-Grade Cervical Lesions: A Retrospective Analysis by Human Papillomavirus Genotype.Diagnostics (Basel, Switzerland) · 2026Article
- Diagnostic Accuracy of DNA Methylation Markers for Detecting Cervical Precancer and Cervical Cancer: A Systematic Review and Meta-analysis.Archives of academic emergency medicine · 2026Review
- Cervical cytology screening in a newly established government medical college: A bethesda-based reporting analysis.Bioinformation · 2026Article
- Demographic and Screening-to-Diagnosis Cascade Indicators for Risk Stratification in an Organized Cervical Cancer Screening Program: Evidence from 82,141 Women in Yunnan, China.International journal of women's health · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
objectiveTo evaluate the clinical performance of triage strategies for HPV-positive women in rural Yunnan, China, with the aim of optimizing HPV test-based cervical cancer screening.
methodsWe recruited 417 HPV-positive women, who additionally underwent mRNA testing, AI-assisted cytology, PAX1 and SOX1 DNA methylation testing. We compared the sensitivity, specificity, area under the curve (AUC), and number needed to colposcopy for one cervical lesion detection of several triage approaches, for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+).
resultsAmong single triage strategies, cytology demonstrated a sensitivity of 54.2% (95% CI: 33.2%-73.8%), a specificity of 75.1% (95% CI: 70.4%-79.2%), an AUC of 0.65 (95% CI: 0.53-0.77), and an number needed to colposcopy for one lesion detection of 8.5. Compared with cytology, PAX1 methylation exhibited superior sensitivity (87.5%, 95% CI: 66.5%-96.7%) and specificity (90.6%, 95% CI: 87.1%-93.2%), with an improved AUC of 0.89, and a reduced colposcopy referral of 2.8. Adding SOX1 to PAX1 maintained sensitivity (87.5%) but slightly reduced specificity (88.3%), resulting in an AUC of 0.88. mRNA testing showed higher sensitivity (75.0%) but lower specificity (44.5%) and a declined AUC (0.60). Among combined triage strategies, HPV-16/18 genotyping with reflex cytology for non-16/18 types yielded a sensitivity of 62.5%, a specificity of 54.5%, and an AUC of 0.59. HPV-16/18 genotyping with reflex PAX1/SOX1 methylation improved sensitivity to 91.7% and specificity to 64.1%, with an AUC of 0.78.
conclusionPAX1 methylation triage demonstrated better clinical performance and required fewer colposcopy referrals than cytology triage. It showed good potential as an triage strategy for HPV-positive women in rural Yunnan. The addition of SOX1 methylation or integration with HPV genotyping did not significantly enhance its clinical performance.
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