King Edward Memorial Hospital - Colposcopy Clinic

WNHS offers a comprehensive diagnostic, treatment and management service for women with an abnormal cervical screening test result, a co-test result requiring further investigation or abnormal vaginal bleeding requiring colposcopy.

Colposcopy clinics are also available at SJOG Midland Hospital, Fiona Stanley Hospital, Armadale Hospital, Rockingham General Hospital and Joondalup Hospital.

Clinical inclusion

Women should be referred to the Colposcopy Clinic for:

Investigation following abnormal cervical screening testing (CST) result requiring colposcopy as indicated in National Cervical Cancer Screening guidelines.
For investigation of persistent post-coital bleeding following a co-test CST.

Follow the referral pathways below:

HealthPathwaysWA
Cervical Screening (external site)
National Cervical Screening Program
Symptomatic Women, when to order a co-test (external site)
Investigation of Abnormal Vaginal Bleeding Flowchart (PDF)

Since 1 February 2021, there has been a change to the testing and referral pathways for cervical screening test results reported as HPV detected type NON 16/18. Please refer to National Cervical Screening Programme website (external site).

For further information and the new flowchart (PDF) to guide management of these results.

Clinical exclusion

Women with an obvious clinical cancer of vulva, vagina or cervix should be referred urgently following discussion with the On Call Gynaecologic Oncology Fellow or Consultant on (08) 6458 2222.
Women with post-menopausal bleeding requiring further investigation – refer to general gynaecology clinic after co-test and pelvic ultrasound to assess endometrial thickness.

Frequency of clinic

Nine clinics per fortnight.

Referral to include

History of symptoms if present – post-coital bleeding, blood-stained discharge, unexplained intermenstrual bleeding, post-menopausal bleeding.
Current Cervical Screening Test (CST) result.
Clearly indicate if the CST was a co-test performed due to symptoms (post-coital bleeding, blood-stained discharge, unexplained intermenstrual bleeding, post-menopausal bleeding.)
OR if the CST was performed as part of routine screening program.
History of CST and pap smears and copies of results (available via PRODA (external site)).
Copies of results of other investigations, if performed.
Past medical and surgical history, exposure to DES, medications and allergies.

For post-menopausal women, and women experiencing urogenital syndrome of menopause.

Prescribe vulval / vaginal oestrogen cream (if no contra-indications to use) to use for a minimum of four weeks prior to their scheduled colposcopy appointment:

Oestriol cream (Ovestin cream) use nightly for two weeks PV and then three times a week thereafter.
Or oestradiol pessary (Vagifem low) use nightly for two weeks PV and then three times a week thereafter.

The use of vaginal oestrogen will minimise the discomfort post-menopausal women experience during speculum examination and the colposcopy procedure and improves the visualisation of the cervix during the procedure.

Urgent referral

Contact the On Call Gynaecology Registrar (or Consultant if a complex case) on (08) 6458 2222 to discuss urgent cases needing review within seven days.

High risk cases are ideally triaged to be seen within six weeks. Non-urgent cases may have to wait up to 12 months for an appointment.

Referral process

All referrals from GPs to this clinic are sent to the Central Referral Service WA (CRS). Ensure you provide the relevant information in the referral to enable appropriate triage, including required investigation results and letters from treating medical practitioners if relevant and request colposcopy clinic at WNHS.

Referrals using GP software that include all the relevant history and information are also welcome using CRS referral form templates (external site).

Referrals are sent to the Central Referral Service of WA via:

Healthlink secure messaging: crefserv
Tel: 1300 551 142
Fax: 1300 365 056
Email: centralreferralservice@health.wa.gov.au
Postal address: GPO Box 2566, Perth WA 6831