Cervical cancer screening has evolved significantly since the PAP smear was introduced in 1949. In particular, the association with human papillomavirus (HPV) infection and the mechanism of HPV-related carcinogenesis have been elucidated over the last 20 years. Diagnostics quickly followed focusing on the presence or absence of HPV. Because HPV is ubiquitous and the presence of a high risk type of HPV results in high grade cervical lesions in a small number of instances, the field has realized that infection by HPV is not enough to appropriately triage affected individuals into treatment categories. Detection of HPV DNA has high sensitivity (95%+) for high grade cervical lesions but low specificity (