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Article History

Received: 11 November 2025

Accepted: 4 January 2026

First Online: 23 January 2026

Declarations

:

: This work was funded by the Dutch Cancer Society (KWF Kankerbestrijding; grant numbers 10382 and 17009).

: R.D.M. Steenbergen is a minority shareholder of Self-screen B.V., which develops, manufactures and licenses high-risk HPV and methylation marker assays and holds patents on these tests. R.D.M. Steenbergen also declares consultancy fees from AstraZeneca paid to her institution. All the other authors declare that they have no competing interests.

: The data generated in this study are available upon reasonable request from the corresponding author.

: For the use of archived material, we adhered to the Code of Conduct for Responsible Use of Left-over Material of the Dutch Federation of Biomedical Scientific Societies. Ethical approval was granted by the Medical Ethical Committee of the Amsterdam UMC, location VUmc, for the collection and use of healthy vulvar samples (reference number 2017.626), for the collection and use of high-grade VIN, LSIL and LS samples (2017.561) and for the collection and use of vulvar cancer samples (2021.671).

: Conceptualization: JB, RDMS and MCGB. Methodology: DCV, FR, JB, RDMS and MCGB. Formal analysis: DCV and FR. Interpretation: DCV, FR, JB, RDMS and MCGB. Investigation: SD. Supervision: RDMS and MCGB. Visualization: DCV and FR. Writing—original draft: DCV and FR. Writing—review and editing: DCV, FR, SD, JB, RDMS and MCGB. All authors read and approved the final version of the manuscript.

: Not applicable.

: Not applicable.