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This study reports a prospective evaluation of the diagnostic accuracy of\n                    <jats:italic>FAM19A4\/miR124\u20102<\/jats:italic>\n                    methylation in a large population\u2010based primary HPV\u2010based screening cohort with 18\u2009months of follow\u2010up. In this prospective observational study, clinician\u2010collected cervical samples from 3848 consecutive hrHPV\u2010positive women who participated in the Dutch national primary HPV\u2010based screening program were tested with the QIAsure Methylation Test, a quantitative methylation\u2010specific PCR assessing\n                    <jats:italic>FAM19A4<\/jats:italic>\n                    and\n                    <jats:italic>miR124\u20102<\/jats:italic>\n                    methylation. Through linkage to the Dutch Nationwide Pathology Databank (Palga), 11 cases of cervical carcinoma, 293 cervical intraepithelial neoplasia grade 3 (CIN3), and 29 adenocarcinoma in\u00a0situ (AIS) were identified during 18\u2009months of follow\u2010up. Clinical performance for CIN3, AIS, and cancer (CIN3+) detection was assessed based on (I) the threshold of the QIAsure Methylation Test, and (II) thresholds corresponding with clinical specificities of 70% and 80% in this hrHPV\u2010positive study population. The sensitivity and specificity of\n                    <jats:italic>FAM19A4\/miR124\u20102<\/jats:italic>\n                    methylation for CIN3+ detection using the QIAsure Methylation Test threshold (I) were 57.4% (95% CI: 52.0\u201362.7) and 88.3% (95% CI: 87.2\u201389.5), respectively. At predefined specificities of 70% and 80%,\n                    <jats:italic>FAM19A4\/miR124\u20102<\/jats:italic>\n                    methylation (II) demonstrated a CIN3+ sensitivity of 75.4% (95% CI: 70.7\u201380.0) and 66.1% (95% CI: 61.0\u201371.2), respectively. In conclusion,\n                    <jats:italic>FAM19A4\/miR124\u20102<\/jats:italic>\n                    methylation analysis showed good triage performance in a primary HPV\u2010based screening setting. These findings support the use of methylation\u2010based testing as a triage strategy in primary HPV\u2010based screening programs, with an appropriate follow\u2010up policy for hrHPV\u2010positive women who test methylation\u2010negative.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70626","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T01:59:18Z","timestamp":1782784758000},"page":"2463-2472","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Triage Performance of\n                    <i>FAM19A4\/miR124\u20102<\/i>\n                    Methylation: 18\u2010Month Follow\u2010Up Results From a Prospective Observational Study Within the Dutch Primary\n                    <scp>HPV<\/scp>\n                    \u2010Based Cervical Screening Program"],"prefix":"10.1002","volume":"159","author":[{"given":"Lisanne","family":"Verhoef","sequence":"first","affiliation":[{"name":"Pathology, Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam the Netherlands"},{"name":"Imaging and Biomarkers Cancer Center Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9974-543X","authenticated-orcid":false,"given":"Mila S.","family":"Griffioen","sequence":"additional","affiliation":[{"name":"Pathology, Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam the Netherlands"},{"name":"Imaging and Biomarkers Cancer Center Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maaike C. 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