Abnormal cervical screening /cervical dysplasia/abnormal cervix

Emergency department referrals

All urgent cases must be discussed with the on call Registrar to obtain appropriate prioritisation and treatment. Contact through:

  • Royal Brisbane and Women's Hospital (07) 3646 8111
  • The Prince Charles Hospital (07) 3139 4000
  • Redcliffe Hospital (07) 3883 7777
  • Caboolture Hospital (07) 5433 8888

Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable


  • Invasive cancer (squamous, glandular, other).  For optimum care, patient should be seen by gynaecological oncology (National guidelines suggest being seen at the earliest opportunity for urgent evaluation)
  • Positive HPV 16/18 and
    • Unknown cytology
    • Unsatisfactory LBC
    • Previous treatment for PHSIL/HSIL (National guidelines suggest being seen at the earliest opportunity, ideally within 8 weeks)
    • Past history of positive HPV 16/18 (National guidelines suggest being seen at the earliest opportunity, ideally within 8 weeks)
  • Glandular lesions
    • AIS or possible high grade glandular lesion
    • Any atypical glandular cells/endocervical cells of undetermined significance.

Category 2

Appointment within 90 days is desirable

  • Positive HPV 16/18 and
    • Normal LBC
  • Positive HPV non 16/18 and
    • On 3 consecutive years
    • On 2 consecutive TESTS
      • 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 after STI excluded/treated – 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 and after STI excluded/treated
  • Any abnormal result and past history of excisional treatment of AIS

Category 3

Appointment within 365 days is desirable

  • No category 3 criteria

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

  • Refer to HealthPathways for assessment and management information if available
  • 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) or who 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 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.
  • Routine colposcopic examination is NOT routinely required following treatment for CIN II/III.  These patients would need a speculum inspection of the cervix and a co-test (i.e. HPV and LBC as 12 months post-treatment).  They do not routinely need referral to a specialist.
  • Clinical resources: National Cervical Screening Program: Guidelines for the management of screen-detected abnormalities, screening in specific populations and investigation of abnormal vaginal bleeding

Referral requirements

A referral may be rejected without the following information.

  • 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 or current cervical screening results (LBC should be performed on any sample with positive oncogenic HPV)

Additional referral information (useful for processing the referral)

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

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander
  • 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
  • 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
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • 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.)

Send referral

Hotline: 1300 364 938

Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs

Metro North Central Patient Intake
Aspley Community Centre
776  Zillmere Road

Health pathways

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