Abnormal Cervical Screening/Cervical Dysplasia/Abnormal Cervix

Useful Management Information
  • Refer to local HealthPathways or local guidelines
  • Women who are in follow-up for pLSIL/LSIL cytology in the previous program (pre-renewal NCSP) should have a HPV test at their next scheduled follow-up appointment.
    • If oncogenic HPV is not detected, the women can return to 5-yearly screening
    • If any HPV is detected, the woman should be referred for colposocpic assessment
  • A single Cervical Screening Test may be considered for women between the ages of 20 and 24 years who experienced their first sexual activity at a young age (e.g., before 14 years) orwho had not received the HPV vaccine before sexual activity commenced.
  • Adolescent patients with abnormal HPV should follow the same pathway as adult patients. Patients <25 years old should also have screening for STI as they are a high-risk group.
    Consider using oestrogen cream +/- liquid cytology in post-menopausal patients
  • Patients with positive non-16/18 but normal or LSIL on LBC would not need referral and only a repeat CST in 12 months.  
  • Recall women in 6-12 weeks if they have an unsatisfactory screening report
  • Specific efforts should be made to provide screening for Aboriginal and Torres Strait Islander women.  They should be invited and encouraged to participate in the NCSP and have a 5-yearly HPV test, as recommended for all Australian women.
  • Women who have been treated for HSIL (CIN2/3) do not need a post-treatment colposcopy. These women should have a co-test (HPV and LBC test) performed at 12 months after treatment, and annually thereafter, until she receives a negative co-test on two consecutive occasions, when she can return to routine 5 yearly screening. This is called ‘test of cure’.
  • If, at any time post treatment, the woman has a positive oncogenic HPV (16/18) test result, she should be referred for colposcopic assessment (regardless of the reflex LBC result).
  • If, at any time during Test of Cure, the woman has a LBC prediction of pHSIL/HSIL or any glandular abnormality, irrespective of HPV status, she should be referred for colposcopic assessment.

Clinical resources

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1
(appointment within 30 calendar days)

If you feel your patient meets Category 1 criteria, please mark "urgent" on your referral

  • Invasive cancer (squamous, glandular, other). For optimum care, patient should be seen by gynaecological oncology within 2 weeks. Please address these referrals to Gynaecological oncology at the Mater Hospital
  • AIS or possible high grade glandular lesion
  • Positive HPV 16/18 and
    • 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
  • Positive HPV non 16/18 and
    • Immediately previous CST result pLSIL/LSIL
    • Previous test positive for oncogenic HPV
    • Women aged 70-74
    • Immune deficiency
  • History of diethylstilboestrol (DES) exposure in uteroregardless 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
Standard Referral Information

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

Reason for request

  • 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

Clinical modifiers

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential referral information

Without this information the referral will be returned

  • 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) 

Note: Please direct all Invasive cancer (SCC, glandular, other) referrals to the Mater Hospital as Gynaecological oncology is not provided at West Moreton Health.

Additional Referral Information
  • HPV Vaccination history
  • STI screen result, endocervical swab or first catch urine for chlamydia +/- gonorrhoea NAA
  • History of smoking
Clinical Override

Clinical override of referral criteria may be requested in the following situations:

  • Inability to include essential referral information. If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons.
  • Patient does not meet minimum referral criteria. If the patient does not meet the criteria for referral but the referring practitioner believes that the patient requires specialist review.
  • Presence of clinical modifiers. The presence of clinical modifiers (as listed above in Standard referral information) may impact on the categorisation of a patient.

Include the reason for request for clinical override as part of the referral. Referrals are reviewed by the triaging specialist who determines the most appropriate course of action.

Out of catchment

West Moreton Health is responsible for providing a public health service to people who reside within its catchment area. To appropriately manage demand for service we do not accept referrals from outside this catchment area. If your patient does live outside the West Moreton Health area and it is deemed socially or clinically necessary for their care to be received in the West Moreton Health Service, inclusion of information regarding their particular medical and/or social factors will assist with the triaging of your referral.


To provide feedback about contents on this website or general referral questions please email WM-CPC@health.qld.gov.au or phone 3413 7402.