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itamp;#39;s basically to test instead of one when you put those two together which was the reasoning behind extending that interval from three to five years because you essentially have double protection against something being problematic at that point in time and for the next five years so you have the protection of knowing the cells look normal and thereamp;#39;s no presence of human papilloma virus HPV we now recognize is the cause of 99% plus of cervical cancer changes in cases and so the idea behind checking for HPV is that if HPV is not present then that patient would be at very low almost zero risk but if it is present they are at increased risk with the caveat that most HPV infections do clear in time and about seventy to ninety percent of the cases within a couple years the newer use of the high-risk HPV is just by itself as a three year interval screen itamp;#39;s felt to be a reasonable option for women who are 25 to 65 years old and if they have a negative high risk HPV