Low-grade cytological abnormalities of the cervix can be challenging to manage; while most will clear without intervention, between 10% and 20% could harbour high-grade lesions. Furthermore, low-grade abnormalities represent the largest category of abnormal results. In Scotland, of the 409 000 cervical screening tests that were performed in 2011–2012, 90.9% had a negative result, 1.3% had high-grade cellular changes and 7.8% had low-grade cellular changes.1

The high sensitivity and negative predictive value of human papillomavirus (HPV) DNA testing has been exploited for the risk-stratification of low-grade abnormalities (often referred to as ‘triage’) with practice of this approach varying between and sometimes within countries. In the USA, HPV triage of atypical squamous cells of undetermined significance (ASCUS) is recommended by the American Society for Colposcopy and Cervical Pathology and has been practised for several years, whereas in the UK it was rolled out only last year in England with no definitive plans for introduction …