Approximately 2-3% of cervical smears will be reported as showing low-grade changes. Many of these smears are in fact associated with high-grade cervical intraepithelial neoplasia requiring treatment, but a significant number will be associated with an absence of cervical intraepithelial neoplasia, where surveillance would enable regression of the cytological abnormality. Pathological, economic and psychosocial considerations all contribute to the ongoing debate as to the optimal management strategy.