{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:53:27Z","timestamp":1792450407603,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023452","name":"Hanarth Fonds","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023452","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009709","name":"Stichting De Weijerhorst","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009709","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2023,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Endometrial cancer incidence is rising and current diagnostics often require invasive biopsy procedures. DNA methylation marker analysis of minimally\u2010 and non\u2010invasive sample types could provide an easy\u2010to\u2010apply and patient\u2010friendly alternative to determine cancer risk. Here, we compared the performance of DNA methylation markers to detect endometrial cancer in urine, cervicovaginal self\u2010samples and clinician\u2010taken cervical scrapes. Paired samples were collected from 103 patients diagnosed with stage I to IV endometrial cancer. Urine and self\u2010samples were collected at home. All samples were tested for nine DNA methylation markers using quantitative methylation\u2010specific PCR. Methylation levels measured in endometrial cancer patients were compared to unpaired samples of 317 healthy controls. Diagnostic performances were evaluated by univariable and multivariable logistic regression analysis, followed by leave\u2010one\u2010out cross\u2010validation. Each methylation marker showed significantly higher methylation levels in all sample types of endometrial cancer patients compared to healthy controls (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.01). Optimal three\u2010marker combinations demonstrated excellent diagnostic performances with area under the receiver operating curve values of 0.95 (95% CI: 0.92\u20100.98), 0.94 (0.90\u20100.97) and 0.97 (0.96\u20100.99), for endometrial cancer detection in urine, self\u2010samples and scrapes, respectively. Sensitivities ranged from 89% to 93% at specificities of 90% to 92%. Virtually equal performances were obtained after cross\u2010validation and excellent diagnostic performances were maintained for stage I endometrial cancer detection. Our study shows the value of methylation analysis in patient\u2010friendly sample types for endometrial cancer detection of all stages. This approach has great potential to screen patient populations at risk for endometrial cancer.\n                  <\/jats:p>","DOI":"10.1002\/ijc.34504","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T07:28:55Z","timestamp":1678692535000},"page":"341-351","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["<scp>DNA<\/scp>\n                    methylation testing for endometrial cancer detection in urine, cervicovaginal self\u2010samples and cervical scrapes"],"prefix":"10.1002","volume":"153","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8052-4215","authenticated-orcid":false,"given":"Birgit M. M.","family":"Wever","sequence":"first","affiliation":[{"name":"Department of Pathology Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4422-7381","authenticated-orcid":false,"given":"Rianne","family":"van den Helder","sequence":"additional","affiliation":[{"name":"Department of Pathology Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers  Amsterdam The Netherlands"},{"name":"Department of Gynecologic Oncology, Center of Gynecologic Oncology Amsterdam Antoni van Leeuwenhoek\/Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annina P.","family":"van Splunter","sequence":"additional","affiliation":[{"name":"Department of Pathology Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mignon D. J. M.","family":"van Gent","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Imaging and Biomarkers  Amsterdam The Netherlands"},{"name":"Department of Gynecologic Oncology, Center of Gynecologic Oncology Amsterdam Amsterdam UMC, location Amsterdam Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4226-7208","authenticated-orcid":false,"given":"Jenneke C.","family":"Kasius","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Imaging and Biomarkers  Amsterdam The Netherlands"},{"name":"Department of Gynecologic Oncology, Center of Gynecologic Oncology Amsterdam Amsterdam UMC, location Amsterdam Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes W.","family":"Trum","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Center of Gynecologic Oncology Amsterdam Antoni van Leeuwenhoek\/Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold R.","family":"Verhoeve","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology OLVG, location Oost  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7245-1714","authenticated-orcid":false,"given":"Wilhelmina M.","family":"van Baal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Flevo Hospital  Almere The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-1953","authenticated-orcid":false,"given":"Alicia","family":"Hulbert","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Illinois at Chicago College of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9877-0297","authenticated-orcid":false,"given":"Lisanne","family":"Verhoef","sequence":"additional","affiliation":[{"name":"Department of Pathology Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dani\u00eblle A. M.","family":"Heideman","sequence":"additional","affiliation":[{"name":"Department of Pathology Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Cancer Center Amsterdam, Imaging and Biomarkers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9448-1826","authenticated-orcid":false,"given":"Birgit I.","family":"Lissenberg\u2010Witte","sequence":"additional","affiliation":[{"name":"Cancer Center Amsterdam, Imaging and Biomarkers  Amsterdam The Netherlands"},{"name":"Department of Epidemiology and Data Science Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke E.","family":"van Trommel","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Center of Gynecologic Oncology Amsterdam Antoni van Leeuwenhoek\/Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2327-9839","authenticated-orcid":false,"given":"Renske D. 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