{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:23:17Z","timestamp":1790688197316,"version":"4.1.0"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Clinical Medical Technology Demonstration Base for Genetic Research of Fetal Congenital Heart Disease in Hunan Province","award":["2021SK4036"],"award-info":[{"award-number":["2021SK4036"]}]},{"name":"Hunan Province Children\u2019s Safe Medication Clinical Medical Technology Demonstration Base","award":["2023SK4083"],"award-info":[{"award-number":["2023SK4083"]}]},{"name":"Hunan Provincial Department of Education","award":["21A0043"],"award-info":[{"award-number":["21A0043"]}]},{"name":"Project of Changsha Science and Technology Bureau","award":["KH2201045"],"award-info":[{"award-number":["KH2201045"]}]},{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"crossref","award":["2023JJ30063"],"award-info":[{"award-number":["2023JJ30063"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Changsha Science and Technology Bureau natural science surface project","award":["kq2202030"],"award-info":[{"award-number":["kq2202030"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["32070817"],"award-info":[{"award-number":["32070817"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Current cervical cancer screening guidelines recommend colposcopy referral for women co-positive for high-risk human papillomavirus (hrHPV) and abnormal cytology (\u2265ASC-US). However, cytology exhibits suboptimal sensitivity, and this strategy leads to high colposcopy burdens, especially in populations where non-HPV16\/18 genotypes predominate. We evaluated a novel triage strategy using HPV16\/18 genotyping and PAX1 methylation to optimize resource allocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective cohort study. In a cohort of 3,233 hrHPV-positive women who underwent HPV genotyping, liquid-based cytology (TCT), PAX1 methylation testing, colposcopy, and histopathological confirmation, we compared two strategies: (A) standard referral (hrHPV+ &amp; TCT \u2265 ASC-US); (B) novel referral (HPV16\/18+ \u2192 immediate colposcopy; non-16\/18 hrHPV+ \u2192 colposcopy if PAX1 methylation \u0394Ct \u2264 8.79). CIN3+ (CIN3 or cancer) served as the clinical endpoint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Non-16\/18 hrHPV types (especially HPV52\/58) accounted for over 30% of infections and 60% of CIN2+ lesions. PAX1 methylation was strongly associated with lesion severity (median \u0394Ct: chronic cervicitis 17.92 vs. CIN3 7.36 vs. cancer 5.97;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and predicted CIN3+ with high accuracy (AUC = 0.82 in non-16\/18 group). Strategy B detected 40 additional CIN3+ cases (+30.5%), reduced colposcopy referrals by 853 cases (absolute \u221225%, relative \u221246%), and increased the positive predictive value (PPV) from 6.6% to 14.6% (2.2-fold improvement) compared to Strategy A.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A triage algorithm combining HPV16\/18 genotyping with PAX1 methylation significantly enhances CIN3+ detection while substantially reducing immediate colposcopies. This strategy is particularly well-suited for Chinese and other Asian populations where non-16\/18 hrHPV types are prevalent, offering a more precise, cost-effective approach toward WHO\u2019s 2030 cervical cancer elimination goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748261442617","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T12:48:58Z","timestamp":1775566138000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["HPV16\/18 Genotyping Combined With PAX1 Methylation Triage Reduces Immediate Colposcopy While Improving CIN3+ Detection: A Real-World Study of 3,233 Chinese Women"],"prefix":"10.1177","volume":"33","author":[{"given":"Xing","family":"Fan","sequence":"first","affiliation":[{"name":"Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal 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