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Although primary HPV testing provides high negative predictive value in screening, women who screen positive for HPV need triage using methods that have an optimal balance between sensitivity for precancer and the number of colposcopies required for detection. The triage test ideally should maximize specificity while also reassuring patients who test negative, although it should be acknowledged that no screening or triage test can entirely exclude disease in a screen\u2010positive patient. While cervical cytology (the Papanicolaou test) triage of primary HPV screen\u2010positive patients is currently recommended by most screening strategies, additional triage tests, specifically extended HPV genotyping and combined p16\/Ki\u201067 dual\u2010stain immunocytochemistry, are now approved by the US Food and Drug Administration and incorporated into cervical cancer screening and management guidelines. Incorporating these triage methods into practice should be achieved by using appropriate validation\/verification and implementation steps and, in the case of dual\u2010stain immunocytochemistry, appropriate cytologist\/cytopathologist training. The US Food and Drug Administration approval of vaginal self\u2010collection in May 2024 is another significant advance for increasing access to screening. These samples can only be tested using primary HPV screening platforms, and guidance for management has been endorsed by the ASCCP's enduring guidelines process. This review discusses issues that warrant consideration before implementation and provides practical guidance for the incorporation of self\u2010collected specimens and extended genotyping\/dual\u2010stain tests into the workflow of the cytopathology laboratory.<\/jats:p>","DOI":"10.1002\/cncy.70006","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:18:18Z","timestamp":1741738698000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Extended HPV genotyping and dual stain for the triage of primary HPV screen\u2010positive cases: Practical guidance for the cytopathology laboratory"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2704-6773","authenticated-orcid":false,"given":"Robert A.","family":"Goulart","sequence":"first","affiliation":[{"name":"Department of Pathology University of Massachusetts Memorial Health and University of Massachusetts Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritu","family":"Nayar","sequence":"additional","affiliation":[{"name":"Department of Pathology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lorey","sequence":"additional","affiliation":[{"name":"The Permanente Medical Group Kaiser Permanente Regional Laboratory  Berkeley California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Joste","sequence":"additional","affiliation":[{"name":"Department of Pathology University of New Mexico Health Sciences Center  Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark H.","family":"Stoler","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Virginia Health  Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,8]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000332302"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000331545"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/94.2.102"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.52.6.342"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.07.024"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.13024"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2022\u20100023\u2010cp"},{"key":"e_1_2_15_9_1","volume-title":"Standards and Guidelines","author":"Commission on Accreditation of Allied Health Education Programs (CAAHEP)","year":"2024"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/lgt.0000000000000525"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008587.pub2"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2015.11.020"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002388"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21628"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22733"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21786"},{"key":"e_1_2_15_17_1","volume-title":"Notable 2024 Final Recommendations","author":"US Preventive Services Task Force (USPSTF)","year":"2024"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.10897"},{"key":"e_1_2_15_19_1","volume-title":"Draft Recommendation Statement: Cervical Cancer Screening","author":"US Preventive Services Task Force (USPSTF)","year":"2024"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/lgt.0000000000000804"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.epi\u201021\u20100865"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/lgt.0000000000000802"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000865"},{"key":"e_1_2_15_24_1","unstructured":"US Food and Drug Administration (FDA).FDA Roundup: May 17 2024. 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