What are the referral criteria for patients with abnormal cytology results from cervical screening?

For patients with abnormal cervical cytology results from cervical screening, referral to colposcopy is typically indicated ¹.

Abnormal cytology results that may lead to referral include borderline changes in squamous or endocervical cells, low-grade dyskaryosis, high-grade dyskaryosis (moderate or severe), invasive squamous cell carcinoma, or glandular neoplasia ¹.

Specifically, if a patient tests positive for high-risk human papillomavirus (hrHPV) and their cytology is reported as abnormal, they must be referred to colposcopy ¹. This applies to initial abnormal cytology after a positive hrHPV test, as well as abnormal cytology at 12 or 24 months in the follow-up pathway ¹.

Referral to colposcopy is also required for certain inadequate cytology results ¹. This includes people who have inadequate cytology at the 24-month repeat test ¹. Additionally, people who have two consecutive unavailable hrHPV results or inadequate cytology results, in any combination, are referred to colposcopy ¹.

Separately, if a physical examination identifies an appearance of the cervix consistent with cervical cancer, a suspected cancer pathway referral should be considered ⁴.