Optimal timeframes & summary
Timeframes to treatment: Timeframes should be informed by evidence-based guidelines (where they exist) while recognising that shorter timelines for appropriate consultations and treatment can reduce women’s distress. The following recommended timeframes are based on expert advice from the Cervical Cancer Working Group.
Timeframes for care
| Step in pathway | Care point | Timeframe |
| Presentation, initial investigations and referral | 2.1 Assessments by the general or primary medical practitioner | Screening test results should be available and the woman reviewed by the general practitioner within 30 days |
| 2.2 Referral to a specialist | • Women with a positive oncogenic HPV (any type) test result and reflex liquid-based cytology (LBC) report of invasive cancer
should have a specialist appointment with a gynaecological oncologist within two weeks of the suspected diagnosis • Women with a positive oncogenic HPV (16/18) test result and reflex LBC prediction of any abnormality should be referred for a colposcopic assessment within eight weeks • Women with a positive oncogenic HPV (not 16/18) test result, with a LBC prediction of pHSIL/HSIL or any glandular abnormality, should be referred for a colposcopic assessment within eight weeks • Women with a suspected diagnosis of cervical cancer (symptomatic, abnormal cervix) should have a specialist appointment with a gynaecological oncologist within two weeks of the suspected diagnosis |
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| Diagnosis, staging and treatment planning | 3.1 Diagnostic work-up | • For obvious abnormalities, a colposcopy within two weeks of referral
• Diagnostic investigations should be completed within two weeks of specialist review |
| 3.3.1 The optimal timing for multidisciplinary team planning | All newly diagnosed women should be discussed in a multidisciplinary team meeting so a treatment plan can be recommended | |
| Treatment | 4.2.1 Surgery for primary disease | Treatment should begin within four weeks of the decision to treat |
| 4.2.2 Radiation therapy | Treatment should begin within four weeks of the decision to treat | |
| 4.2.3 Chemotherapy | Treatment should begin within four weeks of the decision to treat |
The optimal care pathway outlines seven critical steps in the patient journey. While the seven steps appear in a linear model, in practice, patient care does not always occur in this way but depends on the particular situation (such as the type of cancer, when and how the cancer is diagnosed, prognosis, management, the woman’s decisions and the woman’s physiological response to treatment).
The pathway describes the optimal cancer care that should be provided at each step. The pathway includes all squamous cell, glandular (adeno) and mixed-cell cervical carcinomas. Squamous cell carcinomas account for 65–70 per cent of cervical cancers, and adenocarcinomas account for 20–25 per cent (AIHW 2018).
Rare histologies such as neuroendocrine, melanoma and serous are outside the scope of this optimal care pathway.
‘Women’ is the general term used throughout this optimal care pathway; however, the advice in this pathway also applies to all people who have a cervix including transgender and intersex people.
In Australia cervical cancer accounts for less than two per cent of all female cancers, with a relatively low incidence of seven new cases per 100,000 women per year (AIHW 2017).
