2.2 Referral to a specialist
If the diagnosis is suspected or confirmed with initial tests, then referral to a certified gynaecological oncologist who is a member of a multidisciplinary team is optimal.
Referral should include relevant past history, current history, family history, examination, investigations, psychosocial issues and current medications.
Timeframes should be informed by evidence-based guidelines (where they exist) while recognising that shorter timelines for appropriate consultations and treatment can reduce the woman’s distress.
The following recommended timeframes are based on expert advice from the Cervical Cancer Working Group(1):
- Cervical testing results should be available and the woman reviewed by her general practitioner within 30 days.
- Women with a positive oncogenic HPV (any type) test result and 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.
The supportive and liaison role of the general practitioner and practice team in this process is critical.
1: The multidisciplinary experts group who participated in a clinical workshop to develop content for the cervical cancer optimal care pathway are listed in the acknowledgements list.
