Abnormal cervical screening/cervical dyspasia/abnormal cervix

This condition is treated in the Gynaecology clinic.

Emergency Referral Criteria

Criteria for Emergency include: 

• Ectopic pregnancy 
• Ruptured haemorrhagic ovarian cyst 
• Ovarian torsion 
• Acute/severe pelvic pain 
• Significant or uncontrolled vaginal bleeding 
• Severe infection 
• Abscess intra pelvis or PID 
• Bartholin's abscess/acute painful enlargement of a Bartholin's gland/cyst 
• Acute trauma including vulva/vaginal lacerations, haematoma and/or penetrating injuries 
• Post-operative complications within 6 weeks including wound infection, wound breakdown, vaginal bleeding/discharge, retained products of conception post-op, abdominal pain 
• Urinary retention 
• Acute urinary obstruction 
• Any molar pregnancy 
• Inevitable and/or incomplete miscarriage 
• Hyperemesis gravidarum 
• Ascites, secondary to known underlying gynaecological oncology 

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Statewide Referral Criteria (SRC)

Criteria for referral to public hospital specialist clinic services

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Urgent (Category 1)

Referrer note - Invasive cancer (squamous, glandular, other), please refer to Gynaecological Oncology as an urgent referral. 

• Liquid Based Cytology of possible High-grade Squamous Intraepithelial Lesion (PHSIL)/ High-grade Squamous Intraepithelial Lesion (HSIL) 
• AIS (Adenocarcinoma in situ) or possible high grade glandular lesion 
• Positive Human Papilloma Virus (HPV) 16/18 and one or more of the following also present: 
  • unknown cytology 
  • unsatisfactory LBC (Liquid based cytology) 
  • previous treatment for possible High-grade Squamous Intraepithelial Lesion (PHSIL) /High-grade Squamous Intraepithelial Lesion (HSIL) 
  • past history of positive Human Papilloma Virus (HPV) 16/18 
  • Atypical glandular cells/endocervical cells of undetermined significance 
• Positive Human Papilloma Virus (HPV) non-16/18 and Atypical glandular cells/endocervical cells of undetermined significance 
• Any episode of unexplained vaginal bleeding (including post-coital) in a post-menopausal patient 

Semi-urgent (Category 2)

• Positive Human Papilloma Virus (HPV) 16/18 and: 
  • normal Liquid Based Cytology (LBC) 
  • possible Low-grade Squamous Intraepithelial Lesion (PLSIL)/Low-grade Squamous Intraepithelial Lesion (LSIL) 
• Positive Human Papilloma Virus (HPV) non-16/18 and:  
  • on 3 consecutive yearly tests 
  • on 2 consecutive yearly tests, also advise if any of the below are applicable: 
    • 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 
  • on a single test, also advise if any of the below are applicable: 
    • women aged over 70
    • immune deficient women 
    • women currently undergoing Test of Cure following treatment of histological HSIL 
• History of diethylstilboestrol (DES) exposure in utero regardless of Human Papilloma Virus (HPV) status or Liquid Based Cytology (LBC) test 
• Abnormal appearing cervix with normal cervical screening 
• Recurrent (2 or more episodes) post-coital bleeding in pre-menopausal woman 
• Unexplained persistent unusual vaginal discharge, especially if offensive and blood stained 
• Any abnormal cervical test result and past history of excisional treatment of AIS (Adenocarcinoma in situ) 

Routine (Category 3)

• Nil category 3 criteria

Information to be included in the referral

(Referral may be returned without this)

Essential supporting information

Pathology

• Cervical screening

Imaging

• Any relevant

Investigations/other

• Any relevant

Additional information

• 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 

Interim/GP management

To refer a patient with this condition, please see the Gynaecology clinic page for the full referral process and templates.

For more information please see the HealthPathways Tasmania website.

Additional resources

View all clinic availability