Methylation markers FAM19A4 and miR124-2 as triage strategy for primary human papillomavirus screen positive women: A large European multicenter study

Jesper Bonde, Arno Floore, Ditte Ejegod, Frederique J Vink, Albertus Hesselink, Peter M van de Ven, Anja Oštrbenk Valenčak, Helle Pedersen, Saskia Doorn, Wim G Quint, K Ulrich Petry, Mario Poljak, Grazyna Stanczuk, Kate Cuschieri, Silvia de Sanjosé, Maaike Bleeker, Johannes Berkhof, Chris J L M Meijer, Daniëlle A M Heideman

Research output: Contribution to journalArticleAcademicpeer-review


In HPV cervical cancer screening, cytology is used as triage to counter the low specificity of HPV testing. VALID-SCREEN is a EU-multicentre, retrospective study conducted to evaluate the clinical performance of the FAM19A4/miR124-2 methylation-based molecular triage test as a substitute or addition to cytology as reflex testing of HPV screen positive women. FAM19A4/miR124-2 methylation test (QIAsure™ Methylation Test) was evaluated in 2384 HPV-positive cervical screening samples, from women 29-76 years of age, derived from four EU countries. Specimens were collected in ThinPrep or SurePath media, HPV-status, concurrent cytology, and histology diagnosis were provided by the parent institutes. The control population consisted of women with no evidence of disease within two years of follow-up. A total of 899 histologies were retrieved; 527 showed no disease, 124 CIN2 (5.2%), 228 CIN3 (9.6%) and 20 cervical cancers (0.8%); 19 of 20 screen-detected cervical cancers were found methylation-positive (sensitivity 95%). Overall specificity of FAM19A4/miR124-2 methylation test was 78.3% (n=2013; 95%CI: 76-80). The negative predictive value of hrHPV positive, methylation-negative outcomes were 99.9% for cervical cancer (N=1694; 95%CI: 99.6-99.99), 96.9% for ≥CIN3 (95%CI: 96-98), and 93.0% for ≥CIN2 (95%CI: 92-94). Overall sensitivity for CIN3 using FAM19A4/miR124-2 methylation test was 77% (n=228; 95%CI: 71-82). CIN3 sensitivity was uniform between centers independent of sample collection medias, DNA extraction methods and HPV screening tests. Being objectively reported compared to the subjectivity of cytology, equally performing across settings and screening methods, the FAM19A4/miR124-2 methylation constitute an alternative/supplement to cytology as triage method to be investigated in real-life pilot implementation. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)396-405
Number of pages10
JournalInternational Journal of Cancer
Issue number2
Early online date30 Sep 2020
Publication statusPublished - 15 Jan 2021

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