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Abnormal cervical screening / cervical dysplasia / abnormal cervix


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Invasive cancer (squamous, glandular, other). For optimum care, patient should be seen by gynaecological oncology within 2 weeks.
    • AIS or possible high grade glandular lesion
    • Positive HPV 16/18 and
      • unknown cytology
      • unsatisfactory LBC
      • previous treatment for PHSIL/HSIL
      • past history of positive HPV 16/18
      • Atypical glandular cells/endocervical cells of undetermined significance
    • Positive HPV non-16/18 and
      • Atypical glandular cells/endocervical cells of undetermined significance
  • Category 2
    (appointment within 90 calendar days)
    • Positive HPV 16/18 and
      • normal LBC
      • PLSIL/LSIL
    • Positive HPV non 16/18 and
      • Persistent positive non 16/18 HPV or HPV other
      • on 3 consecutive yearly tests or
      • in a person who is:
        • two or more years overdue for screening at the time of the initial screen
        • identifies as Aboriginal or Torres Strait islander
        • aged 50-69 years
      • women aged 70+
      • immune deficient women
      • women currently undergoing Test of Cure following treatment of histological HSIL
    • History of diethylstilboestrol (DES) exposure in utero regardless of HPV status or LBC test
    • Abnormal appearing cervix with normal cervical screening
    • Recurrent post-coital bleeding in pre-menopausal woman – gynaecological assessment recommended
    • Any episode of unexplained vaginal bleeding (including post-coital) in a post-menopausal woman
    • Unexplained persistent unusual vaginal discharge, especially if offensive and blood stained
    • Any abnormal result and past history of excisional treatment of AIS
  • Category 3
    (appointment within 365 calendar days)
    • No category 3 criteria

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • History of
    • any abnormal bleeding (i.e. post-coital and intermenstrual)
    • unexplained persistent deep dyspareunia or unexplained persistent unusual vaginal discharge
    • previous abnormal cervical screening results and any treatment
    • immunosuppressive therapy
  • Medical management to date
  • Most recent and current cervical screening results (LBC should be performed on any sample with positive oncogenic HPV)

3. Additional referral information Useful for processing the referral

  • BMI
  • HPV vaccination history
  • STI screen result - endocervical swab or first catch urine for chlamydia +/- gonorrhoea NAA
  • History of smoking

4. Request

Last updated: 21 June 2023