Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Consider referring a patient for further investigation of human papillomavirus (HPV)-related lesions in the following situations:
- If cervical screening shows inadequate cytology results twice consecutively or if the high-risk HPV (hrHPV) test result is unavailable or inadequate, refer the patient to colposcopy for detailed assessment NICE CKS.
- If colposcopy reveals abnormal changes suggestive of cervical intraepithelial neoplasia (CIN) or cancer, or if cytology shows borderline changes, low-grade or high-grade dyskaryosis, or glandular neoplasia, refer for further specialist evaluation NICE CKS.
- For persistent or unexplained penile lesions or masses after exclusion or treatment of sexually transmitted infections, arrange urgent referral via a two-week suspected cancer pathway to exclude penile intraepithelial neoplasia or malignancy NICE CKS.
- Women with vulval lumps or ulcers that are unexplained should be referred urgently via a suspected cancer pathway NICE NG12.
- Adults with anogenital lesions caused by molluscum contagiosum should be referred to genito-urinary medicine for STI screening, and referral to specialists is indicated if lesions are extensive, painful, or if the patient is immunocompromised NICE CKS.
Encourage participation in the NHS cervical screening programme for women aged 25–64 years and HPV vaccination for girls aged 12–13 years to prevent HPV-related lesions and cancers NICE CKS.