{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:44:37Z","timestamp":1786977877291,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","award":["634570"],"award-info":[{"award-number":["634570"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","award":["742432"],"award-info":[{"award-number":["742432"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011035","name":"Standortagentur Tirol","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011035","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":[[2026,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The DNA methylation\u2010based WID\u2010qEC test, applied to cervico\u2010vaginal samples, has been validated for the accurate detection of endometrial and cervical cancers. However, a small proportion of women test positive despite the absence of these cancers. The aim of this study was to explore the biological and clinical characteristics associated with such WID\u2010qEC\u2010positive cases to inform potential follow\u2010up strategies. We analyzed 1269 cervico\u2010vaginal samples from women without endometrial or cervical cancer, including healthy controls (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009624), women with benign gynecological conditions (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009324), and ovarian cancer cases (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009321). Of the 80 WID\u2010qEC\u2010positive results, 43 (54%) were from women with ovarian cancer. WID\u2010qEC positivity was associated with the presence of ovarian cancer (adjusted odds ratio [OR] 2.93; 95% CI 1.75\u20134.95) and with a higher number of lifetime ovulatory cycles (adjusted OR 2.67; 95% CI 1.06\u20137.50), a known ovarian cancer risk factor. Both associations were independent of age, menopausal status, hormone replacement therapy usage, or family history of breast or ovarian cancer. Our findings suggest that in the absence of endometrial or cervical cancer, WID\u2010qEC positivity may indicate an elevated risk or presence of ovarian cancer. While the standalone positive predictive value (PPV) for ovarian cancer detection remains low in the general population, we outline how WID\u2010qEC could be used in a two\u2010step triage approach. In women presenting with abnormal bleeding, combining WID\u2010qEC positivity with a highly specific plasma\u2010based cell\u2010free DNA methylation test (e.g., with 60%\u201380% sensitivity and ~98.4% specificity) could theoretically yield a PPV of around 30%\u201340%. This hypothetical modeling is intended solely to illustrate how WID\u2010qEC positivity might inform future triage research, rather than to propose a clinical diagnostic algorithm.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70354","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:17:34Z","timestamp":1769696254000},"page":"2530-2536","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The cervico\u2010vaginal\n                    <scp>DNA<\/scp>\n                    methylation\n                    <scp>WID<\/scp>\n                    \u2010\n                    <scp>qEC<\/scp>\n                    test: An epigenetic marker associated with ovarian cancer in the absence of endometrial and cervical cancer"],"prefix":"10.1002","volume":"158","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6540-8443","authenticated-orcid":false,"given":"Elisa","family":"Redl","sequence":"first","affiliation":[{"name":"European Translational Oncology Prevention and Screening (EUTOPS) Institute Universit\u00e4t Innsbruck  Hall in Tirol Austria"},{"name":"Research Institute for Biomedical Aging Research Universit\u00e4t Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1572-498X","authenticated-orcid":false,"given":"Chiara","family":"Herzog","sequence":"additional","affiliation":[{"name":"European Translational Oncology Prevention and Screening (EUTOPS) Institute Universit\u00e4t Innsbruck  Hall in Tirol Austria"},{"name":"Research Institute for Biomedical Aging Research Universit\u00e4t Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5027-2309","authenticated-orcid":false,"given":"Charlotte","family":"Vavourakis","sequence":"additional","affiliation":[{"name":"European Translational Oncology Prevention and Screening (EUTOPS) Institute Universit\u00e4t Innsbruck  Hall in Tirol Austria"},{"name":"Research Institute for Biomedical Aging Research Universit\u00e4t Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1274-327X","authenticated-orcid":false,"given":"James","family":"Barrett","sequence":"additional","affiliation":[{"name":"European Translational Oncology Prevention and Screening (EUTOPS) Institute Universit\u00e4t Innsbruck  Hall in Tirol Austria"},{"name":"Research Institute for Biomedical Aging Research Universit\u00e4t Innsbruck  Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Women's Cancer, UCL EGA Institute for Women's Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iona","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Women's Cancer, UCL EGA Institute for Women's Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Reisel","sequence":"additional","affiliation":[{"name":"Department of Women's Cancer, UCL EGA Institute for Women's Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjit","family":"Manchanda","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology Barts Health NHS Trust  London UK"},{"name":"Wolfson Institute of Population Health Queen Mary University of London  London UK"},{"name":"Department of Health Services Research, Faculty of Public Health &amp; Policy London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Line","family":"Bj\u00f8rge","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Haukeland University Hospital  Bergen Norway"},{"name":"Centre for Cancer Biomarkers CCBIO, Department of Clinical Science University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Zikan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Bulovka University Hospital  Prague Czech Republic"},{"name":"Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine Charles University  Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cibula","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine Charles University  Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Twana","family":"Alkasalias","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"},{"name":"General Directorate of Scientific Research Centre Salahaddin University\u2010Erbil  Erbil Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelique Fl\u00f6ter","family":"R\u00e5destad","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Gemzell\u2010Danielsson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6736-4907","authenticated-orcid":false,"given":"Louis","family":"Dubeau","sequence":"additional","affiliation":[{"name":"Department of Pathology, Keck School of Medicine, USC\/Norris Comprehensive Cancer Centre University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology University College London Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davor","family":"Jurkovic","sequence":"additional","affiliation":[{"name":"Department of 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