{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:06:31Z","timestamp":1787321191964,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,10,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Type I to III cervical transformation zones (TZ\u20101 to TZ\u20103) may have various effects on cervical cancer screening and diagnostic outcomes. This study aims to evaluate the clinical utility of the cytological\n                    <jats:italic>PAX1<\/jats:italic>\n                    \/\n                    <jats:italic>JAM3<\/jats:italic>\n                    methylation (CISCER) assay in cervical cancer screening, especially in TZ\u20103 women. Between November 2020 and October 2022, 1782 women referred for colposcopy underwent liquid\u2010based cytology (LBC), high\u2010risk human papillomavirus (hrHPV) genotyping, and CISCER testing. After applying inclusion criteria, 1398 women were analyzed, including 1190 with documented TZ classification. Diagnostic performance for detecting cervical intraepithelial neoplasia grade 3 or worse (CIN3+) was compared across TZ subgroups. For CIN3+ detection, CISCER showed sensitivities of 67.4%, 72.0%, 48.3%, and 81.5% and specificities of 91.0%, 94.2%, 91.3%, and 89.8% in all women, TZ\u20101, TZ\u20102, and TZ\u20103, respectively. Compared with LBC \u2265 ASC\u2010US, hrHPV positivity, or HPV16\/18 positivity, CISCER achieved the highest diagnostic accuracy, with AUC values of 0.792, 0.831, 0.698, and 0.856 across the respective groups. In both the overall cohort and TZ\u20103 subgroup, CISCER positivity was associated with the highest CIN3+ risk (34.6% and 31.4%) and required the fewest colposcopy referrals per CIN3+ detected (2.9 and 3.2). Combining hrHPV testing with CISCER further improved risk stratification. CISCER demonstrated superior diagnostic performance across TZ types, particularly in TZ\u20103, enabling improved CIN3+ risk discrimination while substantially reducing unnecessary colposcopy referrals compared with conventional cytology and HPV genotyping.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70591","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:11:19Z","timestamp":1781237479000},"page":"2084-2096","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Utility of Cytological Methylation Assay in Cervical Cancer Screening Across Various Cervical Transformation Zones"],"prefix":"10.1002","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1926-7918","authenticated-orcid":false,"given":"Xiaoying","family":"Zhong","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"},{"name":"State Key Laboratory for Complex, Severe and Rare Diseases Peking Union Medical College Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8561-046X","authenticated-orcid":false,"given":"Xitong","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"},{"name":"State Key Laboratory for Complex, Severe and Rare Diseases Peking Union Medical College Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3128-6230","authenticated-orcid":false,"given":"Yanan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"},{"name":"State Key Laboratory for Complex, Severe and Rare Diseases Peking Union Medical College Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9783-2203","authenticated-orcid":false,"given":"Xiaopei","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"},{"name":"State Key Laboratory for Complex, Severe and Rare Diseases Peking Union Medical College Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0270-0540","authenticated-orcid":false,"given":"Linghua","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking Union Medical College Hospital  Beijing China"},{"name":"National Clinical Research Center for Obstetric &amp; Gynecologic Diseases  Beijing China"},{"name":"State Key Laboratory for Complex, Severe and Rare Diseases Peking Union Medical College Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0762-4604","authenticated-orcid":false,"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology Peking Union Medical College Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3122-1960","authenticated-orcid":false,"given":"Pei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Beijing Origin\u2010Poly Bio\u2010Tec Co. 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