Methylation analysis for the identification of cervical lesions to improve cervical cancer screening in a Chinese population

Cervical cancer is the fourth most common cancer among women. Cervical cancer is characterized by a well-defined pre-malignant phase and strongly associated with high-risk human papillomavirus (hrHPV) infections. Population-based cervical screening programs have decreased the incidence of cervical cancer significant. In many countries hrHPV testing has recently replaced cytology as primary screening method for the early detection of cervical cancer. Although using hrHPV testing identifies most women with disease, also many women without disease are hrHPV-positive. Cytology is now included as triage method to decrease the number of unnecessary referrals for colposcopy, but still 50% women do not have disease. Therefore, better triage assays are needed. At the UMCG several triage methylation markers have been identified and evaluated to improve early cervical cancer screening.
Na Li investigated the diagnostic performance of several Dutch methylation markers in cervical scrapings collected from Chinese women in Tianjin Hospital. The ability to classify women with and without disease was compared to the diagnostic value of the same markers in a Dutch population. These studies revealed that despite the difference in geographic area and race, the diagnostic value was very comparable between Chinese and Dutch women. The study of Na Li also revealed that methylation marker panels using quantitative methylation-specific PCR can be implemented easily in China. Most importantly, these markers are applicable as triage test in cervical cancer screening in both China and the Netherlands and might decrease the number of unnecessary colposcopies.