Data Sheet 1_The causal integration ladder: a multilevel evidence framework for therapeutic target evaluation in cervical cancer.docx

We present the Causal Integration Ladder (CIL), an evidence-accounting framework that distinguishes Level I association, inherited Level II-G evidence, acquired Level II-S evidence, Level III computational and direct functional evidence, and Level IV translational validation, while treating viral etiology as an explicit context modifier.

An exploratory TCGA-CESC screen (306 tumours, 3 normal samples) supplied 25 Level I candidates. HPV annotations were available for 291 primary tumours (280 positive, 9 negative, 2 indeterminate). Restriction to HPV-positive tumours preserved the direction of all 25 Level I effects; HPV-positive versus HPV-negative comparisons were exploratory because the negative group was small and histologically heterogeneous.