Understanding a patient’s risk of developing cervical cancer is critical to screening and surveillance strategies. Cervical cancer screening with the Papanicolou test is the basis of one of the most successful cancer prevention programs. In the 1980s, the American Cancer Society advised annual Papanicolou testing for women starting at the initiation of sexual activity and continuing for as long as a woman remained in good health, with evaluation of all abnormalities. This simple screening algorithm was successful in preventing cancer but led to unnecessary testing and procedures for many women.