Sumiec Elizabeth G, Yim Zhe Yang, Mohy-Eldin Hannah, Nedjai Belinda
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Centre for Prevention, Diagnosis and Detection, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Infect Agent Cancer. 2024 Dec 18;19(1):62. doi: 10.1186/s13027-024-00623-1.
Cervical cancer (CC) is a preventable disease and treatable cancer. Most of the new cases and deaths from CC occur in Low- and Middle-Income Countries (LMICs) due to cultural and systematic barriers leading to low CC screening uptake. In recent years, self-sampling has been proposed as a method to increase CC screening uptake and is slowly being implemented into screening programmes worldwide. Simultaneously, DNA methylation has been proposed as a novel biomarker that could be used for the triage of self-collected samples that test positive for high-risk types of Human Papillomavirus (HPV). In this paper, we conducted a literature review of studies assessing the efficacy of DNA methylation markers to detect Cervical Intraepithelial Neoplasia (CIN) in self-collected cervicovaginal swabs or urine (2019-2024). Our review showed that, of the available data, DNA methylation together with self-sampling could perform as well as cytology in the detection of CIN as well as improve uptake of CC screening and reduce loss to follow up, especially in LMICs. However, more data is still needed to understand which methylation tests are most efficacious. Future studies should assess the full potential of DNA methylation and self-sampling in large, diverse screening cohorts.
宫颈癌（CC）是一种可预防和可治疗的癌症。由于文化和制度障碍导致宫颈癌筛查参与率低，大多数宫颈癌新发病例和死亡发生在低收入和中等收入国家（LMICs）。近年来，自我采样已被提议作为一种提高宫颈癌筛查参与率的方法，并正在全球范围内缓慢纳入筛查计划。同时，DNA甲基化已被提议作为一种新型生物标志物，可用于对检测出高危型人乳头瘤病毒（HPV）呈阳性的自我采集样本进行分流。在本文中，我们对2019年至2024年评估DNA甲基化标志物在自我采集的宫颈阴道拭子或尿液中检测宫颈上皮内瘤变（CIN）疗效的研究进行了文献综述。我们的综述表明，根据现有数据，DNA甲基化与自我采样在检测CIN方面的表现与细胞学检查相当，同时还能提高宫颈癌筛查的参与率并减少失访，尤其是在低收入和中等收入国家。然而，仍需要更多数据来了解哪种甲基化检测最有效。未来的研究应在大型、多样化的筛查队列中评估DNA甲基化和自我采样的全部潜力。
