{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:02:49Z","timestamp":1790694169789,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["No.2021YFC2701204"],"award-info":[{"award-number":["No.2021YFC2701204"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100022963","name":"Key Research and Development Program of Zhejiang Province","doi-asserted-by":"publisher","award":["No.2023C03169,No.2020C03025"],"award-info":[{"award-number":["No.2023C03169,No.2020C03025"]}],"id":[{"id":"10.13039\/100022963","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To establish a better triage strategy using SOX1\/PAX1 methylation detection for high\u2010risk HPV (hrHPV)\u2010positive women than cytology.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Population\u2010based cervical cancer (CC) screening cohort.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n A total of 5684 women were enrolled.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n SOX1\/PAX1 methylation was detected by quantitative methylation\u2010specific PCR using cytologic residue from hrHPV\u2010positive women at baseline in a 3\u2010year CC screening cohort. Risk stratification ability was evaluated by the immediate and cumulative cervical intraepithelial neoplasia (CIN) grade 2\/3 or worse (CIN2+\/3+) risks.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n CIN3+ and CIN2+.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At baseline, 682 hrHPV\u2010positive women were included with 63 CIN2+ and 39 CIN3+. Over 3\u2009years, 109 CIN2+ and 62 CIN3+ were detected. Methylation demonstrated better risk stratification than cytology among hrHPV\u2010positive women. When compared with current practice triage strategy (Strategy A), post hoc re\u2010triage analysis showed that methylation triage for all hrHPV\u2010positive women (Strategy C) significantly increased sensitivity (97.44%\/83.87% vs. 84.62%\/64.52%,\n p<\/jats:italic>\n \u2009=\u20090.0476\/0.014), specificity (83.36%\/85.00% vs. 73.41%\/73.55%,\n p<\/jats:italic>\n \u2009=\u2009<\u20090.001\/<\u20090.001), positive predictive value (26.21%\/35.86% vs. 16.18%\/19.61%,\n p<\/jats:italic>\n \u2009=\u20090.022\/0.001), and negative predictive value (99.81%\/98.14% vs. 98.74%\/95.40%,\n p<\/jats:italic>\n \u2009=\u20090.040\/0.012) in detecting immediate and 3\u2010year cumulative CIN3+. Similar improvements were observed for methylation triaged for HR12\u2010positive (Strategy B) and for combined HPV and cytology primary screening (Strategy D). More importantly, all methylation\u2010based triage strategies reduced colposcopies and postponed follow\u2010up intervals compared to Strategy A over the 3\u2010year period of CC screening.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n SOX1\/PAX1 methylation showed better risk stratification compared with cytology and enabled more efficient management of HPV\u2010positive women, though external validation and head\u2010to\u2010head comparisons with other triage methods are needed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.70162","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T05:53:35Z","timestamp":1768888415000},"page":"1431-1440","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["SOX1<\/scp>\n \/\n PAX1<\/scp>\n Methylation for Triage of\n HPV<\/scp>\n \u2010Positive Women in Cervical Cancer Screening: A Cohort Study"],"prefix":"10.1111","volume":"133","author":[{"given":"Hongyu","family":"Xie","sequence":"first","affiliation":[{"name":"Clinical Research Center, Women's Hospital, School of Medicine Zhejiang University Hangzhou China"},{"name":"Zhejiang Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Women's Hospital, School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiru","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Women's Hospital, School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansong","family":"Emmanuel","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Women's Hospital, School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Women's Hospital, School of Medicine Zhejiang University Hangzhou China"},{"name":"Department of Gynecologic Oncology Women's Hospital, School of Medicine Zhejiang University Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiguo","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology Women's Hospital, School of Medicine Zhejiang University Hangzhou China"},{"name":"Zhejiang Provincial Clinical Research Center for Gynecological Diseases Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Li","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Women's Hospital, School of Medicine Zhejiang University Hangzhou 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