Introduction/Background Introduction: Cervical cytology is an established method for screening of cervical cancer, but there a lack of consensus regarding management of low grade smears.

This study was undertaken to compare the the performance of HPV 16/18 genotyping with p16/ki67 Dual staining for the detection of High Grade Cervical intraepithelial Neoplasia (HG CIN ) in women with low grade cytology .

Methodology : 89 women between the age of 30–65 years, who had a Cervical Cytology report of ASCUS or LSIL were included. All cases were triaged with Human Papiloma Virus ( HPV ) 16 and 18 testing and also with P16/Ki 67 Dual Staining. All women also underwent Colposcopy and Biopsy from abnormal areas if detected or random cervical biopies were taken.A histopathology report of CIN 2or 3 was considered as true positive. The performance of both methods was evaluated .

Results HGCIN was found in 3.7%of ASCUS cases and 11.5%of LSIL cases. 26.2% of the study population were HPV 16/18 positive ( in ASCUS cases 21.2% and in LSIL cases 33.2% ) and 18.8% were Dual Stain Positive (in Ascus cases13.4% and in LSIS cases27.2% ).Overall the Sensitivity, Specificity, Negative predictive Vaue and Accuracy of HPV 16/18 genotying to detect HGCIN was66.7%, 77.1%,90.1%and 76.2% whereas for Dual staining it was 66.6%, 84.8%,97.1%and 83.5% respectively. For ASCUS cytology, Dual staining had a higher Accuracy than HPV 16/18 genotyping at 86.5% versus 78.5% 16/18 genotypong for the detection of HGCIN. Similarly for LSIL cytology, Dual Staining had a higher Accuray at 78.8% versus 72.7% with 16/18 genotyping

Conclusion Both HPV 16/18 genotyping and Dual Staining are effective triage methods for the detection of HGCIN in women with Low Grade Cytology, but Dual Staining has a higher Specicificity and Accuracy than HPV 16/18 genotyping.