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Molecular markers for cervical cancer screening.
Coşkun Güzel1, Jenny van Sten-Van't Hoff1, Inge M C M de Kok2
1Erasmus MC, Department of Neurology, University of Groningen, Rotterdam, The Netherlands.
Expert Review of Proteomics
|September 23, 2021
Summary
New molecular markers are needed to better identify women at risk for cervical cancer after a positive hrHPV test. This review explores epigenetic and protein markers for improved screening, especially in low-resource settings.
Area of Science:
- Oncology
- Molecular Diagnostics
- Public Health
Background:
- Cervical cancer is a major global health issue, particularly in low- and middle-income countries.
- Human papillomavirus (HPV) testing is effective, but positive results require further triage due to low positive predictive value for high-grade cervical intraepithelial neoplasia (CIN2+).
- Current screening methods necessitate improved molecular markers to accurately identify women needing further gynecological referral.
Purpose of the Study:
- To review current and emerging biomarker tests for cervical cancer screening.
- To explore the potential of epigenetic and protein markers for improved triage of HPV-positive women.
- To address health economic considerations for implementing advanced screening in resource-limited settings.
Main Methods:
- Literature review of biomarker assays including DNA methylation patterns, microRNAs (miRNAs), and protein markers.
- Analysis of the utility of combining nucleic acid-based and protein-based tests for enhanced specificity.
- Examination of challenges in test development and implementation for low- and middle-income countries.
Main Results:
- Biomarker assays based on nucleic acid and protein changes exist but are not widely adopted in population screening.
- Combining different marker types (e.g., epigenetic and protein) may improve specificity in discriminating CIN2+ lesions with different progression risks.
- Developing cost-effective and accurate tests is crucial for reducing unnecessary referrals and preventing cervical cancer globally.
Conclusions:
- There is a critical need for molecular triage tests with higher predictive value to optimize cervical cancer screening.
- Epigenetic and protein marker panels offer promise for improving the accuracy of identifying women at risk.
- Tailored test development for low- and middle-income countries is essential to mitigate the global burden of cervical cancer.
