Executive Summary Improved screening and early detection of cervical changes with the Pap test have helped to greatly reduce the incidence of cervical cancer over the last 40 years. The improved early detection has also reduced cervical cancer mortality rates by 50%, but over 13,000 women are diagnosed annually with cervical cancer and over 4,200 cases will result in death 1 . Most often a Pap test is performed as the primary test with HPV co-testing or reflex testing based on the Pap test results and both tests can be performed on the same sample. Internationally, there is a growing trend to utilize the HPV test alone for primary screening. Not all cervical changes will result in cervical cancer and over treatment can be stressful for patients, effect fertility and are costly, so

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