Table 1 Characteristics of 43 included studies

From: Performance of DNA methylation assays for detection of high-grade cervical intraepithelial neoplasia (CIN2+): a systematic review and meta-analysis

Author, year

Study ID

Country

Study design

First screen test

Sample

Median age (IQR/range)

n CIN2+ (%)a

n ICC (%)

Genes studied

Markers evaluated singly/in combination

Threshold for methylation positivity pre-defined

Van Zummern 201734

C2

South Africa-Pretoria

Cohort

None

321

40 [IQR; 35–46]

94 (29.3%)

2 (0.6%)

CADM1/MAL/miR124-2

Combination only

Yes

Kim 201645

C3

South Korea-Seoul

Convenience

HPV+

122

NR

48 (39.3%)

0 (0.0%)b

ADM1, MAL, PAX1

Single only

Yes

Van Baars 201646

C4

Spain-Barcelona

Convenience

Abnormal cytology

60

33 [19–92]

25 (41.7%)

0 (0.0%)

CADM1/MAL

Combination + single

Yes

De Vuyst 201535

C5

Kenya-Nairobi

Cohort

HR-HPV (Genotyping)

248

37 [33–42]

93 (37.5%)

0 (0.0%)

CADM1/MAL/miR124-2

Combination + single

Obtained from ROC

Verhoef 201526

C6

The Netherlands

Population-based screening—referral population

HR-HPV

364

42 [38–48]

90 (24.7%)

6 (1.6%)

CADM1/MAL

Combination only

Yes

De Strooper 201447

C7

The Netherlands

Convenience

None (HR-HPV >80%)

168

37–48

48 (28.6%)

0 (0.0%)b

CADM1/MAL/MIR124-2

Combination only

Yes

De Strooper 201448

C8

The Netherlands

Convenience

HR-HPV

234

34–40

58 (24.8%)

4 (1.7%)

CADM1/MAL

Combination only

Obtained from ROC

Verhoef 201427

C9

The Netherlands

Population-based screeningreferral population

HR-HPV

1019

43 [33–63]

225 (22.1%)

13 (1.3%)

MAL/MIR-124-2

Combination only

Yes

Hesselink 201432

C10

The Netherlands

Population-based screening– referral population

HR-HPV

355

41 [31–62]

94 (26.5%)

5 (1.4)

CADM1/MAL/MIR124-2

Combination + single

Obtained from ROC

Hesselink 201149

C11

The Netherlands

Convenience

HR-HPV

236

40 [19–62]

58 (24.6%)

4 (1.7)

CADM1/MAL

Combination + single

Yes

Overmeer 201150

C12

The Netherlands

Convenience

HR-HPV

70

34 [21–52]

30 (42.9%)

2 (2.9)

CADM1/MAL

Combination + single

Yes

De Strooper 201630

F1

The Netherlands

Population-based screening – referral population

HR-HPV

254

36 (30–62)

99 (39.0%)

4 (1.6)

FAM194A/MIR1242

Combination only

Yes

Luttmer 201631

F2

The Netherlands

Population-based screening– referral population

HR-HPV

508

~30yrs

180 (35.4%)

3 (0.6)

FAM194A

Single only

Yes

De Strooper 201465

F3

The Netherlands

Convenience

HR-HPV

218

39 (19–62)

52 (23.9)

3 (1.4)

FAM194A

Single only

Yes

Bu, 2018c 37

F4

China-Guangdong

Cohort

HR-HPV

154

NR

57 (37.0)

0 (0.0)

FAM194A

Single only

Obtained from ROC

Kocsis 201724

P1

Hungary

Population-based screening– referral population

HR-HPV

1287

36 (25–40)

91 (7.1%)

12 (0.9%)

POU4F3

Single only

Yes

Kelly 2018 (BF)25

E1

Burkina Faso-Ouagadougou

Case-control

None (HR-HPV >80%)

94

39 (35–43)

28 (29.8)

1 (1.0%)

EPB41L3

Single only

Obtained from ROC

Kelly 2018 (SA)25

E1

South Africa- Johannesburg

Case-control

None (HR-HPV >80%)

268

33 (30–38)

124 (46.3)

0 (0.0%)

EPB41L3

Single only

Obtained from ROC

Lorincz 201642

E2

UK-London

Case-control

HR-HPV (Aptima)

341

NR

39 (11.4)

1 (0.3%)

EPB41L3/HPV-16/-18/-31/-33 (S5 classifier)

Combination only

Pre-defined + ROC

Louvanto 201557

E3

Canada-Montreal

Case-control

HPV16 positive

151

NR

94 (62.3)

0 (0.0%)b

EPB41L3, HPV16

Single only

Yes

Vasiljevic 201428

E4

UK-London

Population-based screening– referral population

HR-HPV

1429

NR

531 (37.2)

0 (0.0%)

EPB41L3

Single only

Obtained from ROC

Boers 201451

E5

The Netherlands

Convenience

HR-HPV

128

NR

34 (26.6)

9 (7.0)

EPB41L3

Single only

Pre-defined + ROC

Eijinsk 201252

E6

The Netherlands-Groningen

Convenience

HR-HPV

200

20–85

66 (33.0)

0 (0.0%)b

EPB41L3

Single only

Yes

van Leeuwan 201829

E7

Slovenia

Population-based screening– referral population

HR-HPV

235

NR

35 (14.9)

3 (1.3)

EPB41L3, SOX1

Single

Yes

Cook 201810

E8

Canada-British Colombia

Case-control

HR-HPV

257

NR

107 (41.6)

0 (0.0)

EPB41L3/HPV-16/-18/-31/-33 (S5 classifier)

Combination

 Obtained from ROC

Boers 201653

E9

The Netherlands-Groningen

Convenience

Cytology ASCUS+

171

20–85

106 (62.0)

0 (0.0%)b

EPB41L3

Single

Yes

Rogeri 201836

E11

Brazil-Sao Paulo

Cohort

None (63% HR-HPV-positive)

402

NR

126 (31.3)

0 (0.0)

EPB41L3, SOX1

Single only

Yes

Xu 201543

PS1

China-Shanghai

Case-control

None (HR-HPV >76%)

94

36–44

34 (36.2)

0 (0.0%)b

PAX1

Single only

Obtained from ROC

Kan 201438

PS2

Taiwan-Taipei

Cohort

None

419

NR

43 (10.3)

4 (1.0)

PAX1, SOX1

Single only

Yes

Lai 201444

PS3

Taiwan

Case-control

Abnormal cytology

346

46

92 (26.6)

30 (8.7)

PAX1, SOX1

Single only

Pre-defined + ROC

Li 201539

PS4

China-Weifang

Cohort

Abnormal cytology (ASCUS+)

463

46 (25–68)

34 (7.3)

2 (0.4%)

PAX1

Single only

Pre-defined + ROC

Lin 201140

PS5

Taiwan

Cohort

Abnormal cytology (ASCUS+)

220

NR

42 (19.1)

11 (5.0)

PAX1

Single only

Yes-but unclear how

Huang 201054

PS6

Taiwan

Convenience

Abnormal cytology

59

 

32 (54.2)

0 (0.0)

PAX1

Single only

Yes

Tian 201741

PS8

Taiwan

Cohort

HR-HPV

173

NR

79 (45.7)

17 (9.8)

PAX1, SOX1

Combination

Yes

Bryant 201558

H16-1

UK-Cardiff

Case-control (HPV16+)

HPV16 positive

200

21 (mean)

145 (72.5)

2 (1.0%)

HPV16-L1/L2

Single only

Obtained from ROC

Mirabello 201559

H16-2

USA-California

Case-control (HPV16+)

HPV16 positive

99

34 [21–64]

59 (59.6)

0 (0.0%)

HPV16-L1

Single only

Obtained from ROC

Qiu 201561

H16-3

China-Zhengzhou

Convenience (HPV16+)

HPV16 positive

114

37 [25–74]

72 (63.2)

11 (9.6)

HPV16-L1

Single only

Yes

Simanaviciene 201562

H16-4

Lithuania-Vilnius

Convenience (HPV16+)

HPV16 positive

126

NR

87 (69.0)

0 (0.0%)b

HPV16-L1

Single only

Yes

Brandsma 201463

H16-5

Senegal-Dakar/USA-New Haven

Convenience (HPV16+)

HPV16 positive

33

34 (23–65)

12 (36.4)

0 (0.0%)b

HPV16-L1/L2/E2

Single only

Yes

Brentnall 201433

H16-6

UK-London

Population-based screening– referral population

Abnormal cytology and HPV16+

1493

NR

556 (37.2)

0 (0.0%)

EPB41L3/HPV-16/-18/-31/-33 (S5 classifier)

Combination only

Obtained from ROC

Lorincz 201355

H16-7

UK-Wales

Cohort (HPV16+)

HPV16 positive

73

NR

25 (34.2)

0 (0.0%)

HPV16-L1/L2

Single only

Pre-defined + ROC

Mirabello 201360

H16-8

Costa-Rica-Guanacaste

Case-control (HPV16+)

Abnormal VI or cyto and HPV16+

273

NR

109 (39.9)

13 (4.8%)

HPV16 L1

Single only

Obtained from ROC

Kottaridi 201756

H16-9

Greece-Athens & UK-London

Case-control (HPV16+)

HPV16 positive

150

36 (21–62)

115 (76.6)

9 (7.8)

HPV16 L1

Single only

Yes

  1. ROC Receiver Operating Characteristics; ASCUS+ atypical squamous cells of undetermined significance, or greater; VI visual inspection; IQR interquartile range
  2. aCIN2+ prevalence among women with a HR-HPV DNA positive test or cytology abnormality or among studies with high prevalence HR-HPV
  3. bCancers were excluded from the analyses due to the high proportion (>10% of all samples)
  4. cFor Bu et al 2018 (F4), 61 (28% of all samples) were cervical cancer cases and were excluded to reduce bias ; Brentnall et al, 2014 (HPV16-6) is evaluated for HPV16 DNA methylation (restricted to HPV16-positive women)