Three different cervical screening methods[cytology,human papillomavirus(HPV) testing and visual inspection with acetic acid(-VIA)]are being considered in China for the national cervical screening program.Comparing risks of CIN3 and cervical cancer (CIN3+) for different results can inform test choice and management guidelines.We evaluated the immediate risk of CIN3+ for dif-ferent screening results generated from individual and combined tests.We compared tests using a novel statistic designed for this purpose called Mean Risk Stratification (MRS),in a pooled analysis of 17 cross sectional population-based studies of 30,371Chi-nese women screened with all 3 methods and diagnosed by colposcopically-directed biopsies.The 3 tests combined powerfully distinguished CIN3+ risk;triple-negative screening conferred a risk of 0.01%,while HPV-positive HSIL+ that was VIA-positive yielded a risk of 57.8%.Among the three screening tests,HPV status most strongly stratified CIN3+ risk.Among HPV-positive women,cytology was the more useful second test.In HPV-negative women,the immediate risks of CIN3+ ranged from 0.01% (negative cytology),0.00% (ASC-US),1.1% (LSIL),to 6.6 (HSIL+).In HPV-positive women,the CIN3+ risks were 0.9% (negative cytology),3.6% (ASOUS),6.3% (LSIL) and 38.5% (HSIL+).VIA results did not meaningful stratify CIN3+ risk among HPV-negative women with negative or ASC-US cytology;however,positive VIA substantially elevated CIN3+ risk for all other,more positive com-binations of HPV and cytology compared with a negative VIA.Because all 3 screening tests had independent value in defining risk of CIN3+,different combinations can be optimized as pragmatic strategies in different resource settings.