Pap smear and HPV test: at what age, and how often?
In Türkiye, cervical cancer screening is offered to women aged 30–65 as a free HPV-DNA test every five years. In women without symptoms, the aim is to catch cell changes before cancer develops. Getting the HPV vaccine does not make screening unnecessary. After age 65, and in women who have had a hysterectomy, whether screening continues is decided individually based on previous results.
Many people cannot remember the answer to "When did I last have a Pap smear?" That is normal. Screening intervals stretch over years, so the schedule is hard to keep in mind. Below you will find the screening schedule by age, the free program in Türkiye, and the special situations in which the schedule changes.
What does screening try to catch?
Cervical cancer usually develops from an infection with high-risk HPV types that lasts for years. Before cancer forms, precancerous cell changes appear in the cervix over a period of years. The aim of screening is to catch exactly this stage. Changes found at this stage can usually be treated with minor procedures.
Screening is not a cancer test. It checks whether high-risk HPV or cell changes are present. A positive result does not mean cancer. It shows that follow-up or further evaluation may be needed.
Screening schedule by age
| Age / situation | General approach |
|---|---|
| Under 30 | Not covered by the national program in Türkiye. Cytology (Pap smear) may be considered based on symptoms, history or your doctor's advice. |
| Ages 30–65 | HPV-DNA test; if the result is normal, repeat every five years. |
| HPV positive | The schedule becomes shorter: individual follow-up with a Pap smear, HPV typing (16/18) and colposcopy if needed. |
| Over 65 | Usually stopped if recent screening has been regular and normal; otherwise it continues. |
This table is a general framework. Your previous results, treatment history and immune status can change the schedule.
Free screening in Türkiye
In Türkiye, the Ministry of Health offers free HPV-DNA screening every five years to women aged 30–65. The test can be done at family health centers, KETEM centers (Cancer Early Diagnosis, Screening and Training Centers) and community health centers.
If your test result is positive, the center following you plans the next step (a Pap smear, HPV typing, or referral for colposcopy). You can read more about what the results mean in the article Pap smear and HPV-DNA test.
Before age 30
HPV infection is very common in young people, but most infections clear on their own within one to two years. At this age, routine HPV testing can lead to unnecessary worry and unnecessary procedures. That is why the national program in Türkiye starts at age 30.
Some international guidelines recommend starting screening with cytology (Pap smear) in your 20s. If you have a symptom before age 30, such as irregular bleeding or bleeding after sex, or a specific history, your doctor will assess whether you need a test.
After age 65
In women whose screening over the past ten years has been regular and normal, screening is usually stopped around age 65. It may continue in these situations:
- You have never been screened, or have been screened irregularly,
- You have had an abnormal result recently,
- You have been treated for high-grade cell changes (CIN2 or higher) within the past 25 years.
Special situations
I have had the HPV vaccine
The vaccine gives strong protection against the HPV types that most often cause cancer, but it does not cover all high-risk types. That is why vaccinated women keep to the same screening schedule. More details: HPV vaccine.
I have had my uterus removed (hysterectomy)
If the uterus and cervix were removed for a benign reason (for example, fibroids) and there is no history of high-grade cell changes before surgery, cervical screening is usually stopped. If the surgery was done because of a precancerous lesion or cancer, follow-up of the vagina continues. If the cervix was left in place (subtotal hysterectomy), screening continues as before. Showing your surgery report to your doctor makes the right decision easier.
I am pregnant
If a pregnant woman is due for screening, the test can be done during pregnancy. The procedure is considered not to harm the pregnancy, though light spotting may occur afterward. The doctor following your pregnancy decides on the timing. More details: HPV in pregnancy.
My immune system is weakened
In conditions such as HIV infection, organ transplantation or use of medicines that suppress the immune system, clearing HPV can be harder. In these people, screening may start earlier and be done more often. The doctors involved decide on the schedule together.
When to see a doctor without waiting for your next screening
The screening schedule is for women without symptoms. In the situations below, you need an evaluation without waiting for your next screening:
Bleeding after sex · bleeding between periods or after menopause · foul-smelling or bloody discharge · persistent pelvic pain. Most of these symptoms have a benign cause, but an examination is needed to find out the cause.
If you do not know when your next screening is due, in Türkiye you can check your test history in e-Nabız (the national personal health record system) or ask your family doctor.
Frequently asked questions
At what age does cervical screening start?
In Türkiye's national program, screening starts at age 30 and uses the HPV-DNA test. Some international guidelines may recommend starting earlier with cytology (Pap smear). Before age 30, your doctor decides whether you need a test based on your symptoms and history.
How often is the HPV test done?
In the national program, if the result is normal, the HPV-DNA test is repeated every five years. If the result is positive, or if you have had an abnormal finding before, the interval is shorter and your doctor sets the follow-up plan.
I have had the HPV vaccine. Do I still need screening?
Yes. The vaccine protects against the HPV types that most often cause cancer, but not against all types. That is why vaccinated women also continue screening when they reach the screening age.
I have had a hysterectomy. Do I still need a Pap smear?
If the uterus and cervix were removed for a benign reason and there is no history of high-grade cell changes before surgery, screening is usually stopped. If the surgery was done because of a precancerous lesion or cancer, follow-up continues. Your doctor will tell you which applies to you.
Does screening stop after age 65?
In women whose screening over the past ten years has been regular and normal, screening is usually stopped around age 65. It may continue in women who have never been screened or who have had a recent abnormal result.
I have no symptoms. Do I still need it?
Yes. Screening is meant exactly for women without symptoms. Precancerous changes in the cervix often cause no complaints at all and can only be found by testing.
Sources
- Republic of Türkiye Ministry of Health, General Directorate of Public Health — Cancer screening (cervix: ages 30–65, HPV-DNA every 5 years)
- World Health Organization (WHO) — Guideline for screening and treatment of cervical pre-cancer lesions (2021)
- National Cancer Institute (NCI) — Cervical Cancer Screening
- ACOG — Cervical Cancer Screening (patient information)
Note: This content was written independently, based on current scientific information published by the institutions above; it is not a direct copy of any text.
This article is for general information only; it is not a diagnosis or treatment recommendation and does not replace a medical examination. Please consult your doctor about your own situation. The content reflects scientific knowledge as of the update date above.