HPV testRO

Cervical cancer · the HPV test

In Romania, cervical cancer kills four times as often as in Sweden

In 2022, cervical cancer killed 12 women per 100,000 in Romania, against 2.7 in Sweden and 3.5 across the European Union, at the same age structure. The disease takes 15–20 years to develop from the first abnormal cells, and an HPV test every three or five years, depending on age, shows who needs follow-up long before those cells turn into cancer. The Romanian state has paid for the test since 2024, but not at the laboratory a family doctor usually sends you to.

This page is written for readers in Romania. Living in the UK? The NHS invites everyone with a cervix aged 25 to 64 every five years: nhs.uk cervical screening.

Don't wait for a screening test if you have symptoms. Bleeding during or after sex, between periods or after the menopause, a change in vaginal discharge, pain during sex, or pain in the lower tummy or lower back: tell a doctor now, whenever your last test was.

When your next test is due

Tell us your year of birth, your last test and your county. Nothing leaves your device.

Last test

An example, until you choose: a woman born in 1990, last Pap smear in 2019, living in Cluj county.

You are 36. Your HPV test is due now. If it is negative, the next one is in 2031. Under today's rules, from your last test until now you would have been called for one test. Your last test was cytology. The next one should be an HPV test; cytology alone is usually repeated every three years under the guidelines that still use it.

  • the test due
  • a test you would have been called for
  • your last test
  • the next ones, if results are negative

Where to get it free in Cluj county

  • At a gynaecologist contracted with the Cluj Health Insurance House for the package “early detection and diagnosis of dysplastic lesions of the cervix”, with a family doctor's referral.
  • Through the CLARA project, if you belong to a vulnerable group: the centre for the Nord-Vest region is Institutul Oncologic „Prof. Dr. Ion Chiricuță” Cluj-Napoca. Ask your family doctor whether they are affiliated.
  • If you cannot find the HPV test: a Pap test on your family doctor's referral, at a laboratory contracted with the Insurance House for cytology.

The HPV vaccine at your age

At 36, a woman gets the HPV vaccine 50% reimbursed until her 46th birthday (three doses).

Which test is due, and how often

Since July 2024 Romania's national screening method (Health Minister's Order 3,735/2024) uses the HPV test as the first test for women aged 25 to 65 without symptoms and at average risk. It looks for 14 high-risk types of HPV in a sample taken from the cervix. The sampling looks the same as for a Pap smear.

The rules of Romania's 2024 national method (Order 3,735/2024).
SituationTestWhen
25 to 29HPV testevery three years after a negative result
30 to 65HPV testevery five years after a negative result
HPV positive, normal cellsHPV testagain after 12 months
unsatisfactory sampleHPV testagain after three months

If the HPV test is positive, the laboratory examines the cells in the same sample (Pap, or Babeș-Papanicolau, cytology). There is no second sampling. The method uses the HPV test because it finds high-grade cell changes more often than cytology, and a negative result is reliable enough for the next test to come five years later.

  • If you are vaccinated, you follow the same screening: the method makes no exception for vaccinated women.
  • If you live with HIV, are on dialysis, are awaiting an organ transplant or have had one, you are tested every year, and a first positive HPV result goes straight to colposcopy. The calculation above does not apply to you.
  • If you have never been sexually active, the risk is very low; the method says no sample is taken when the hymen is intact. Talk to a doctor.
  • Over 65, the programme stops. The symptoms above are a reason to see a doctor at any age.

The Pap smear: what it is still for, and when to have it on its own

Where to get the HPV test free

The National Health Insurance House's rules list “HPV testing” among the prevention tests a family doctor may request. But in the list of laboratory tests the Insurance House pays for, the HPV test has no code and no price, unlike the Pap test (48.70 lei). With a family doctor's referral, a laboratory has nothing to bill the HPV test against. The test is paid for in three other ways.

  1. At a gynaecologist, under the Insurance House package

    The Insurance House pays 198 lei for a package called “early detection and diagnosis of dysplastic lesions of the cervix”: the consultation, the sampling, the HPV test and a second consultation where you get the result. If the test is positive, the extended package (244 lei), which also covers cytology, is billed instead; colposcopy and treatment of lesions have packages of their own.

    What to do: ask your family doctor for a referral to obstetrics and gynaecology, then call the hospital outpatient clinic or the practices contracted with the Insurance House in your county and ask, naming it exactly, whether they hold a contract for this package. The provider list is on the county insurance house's website. You must be insured. The result comes within 30 days.

  2. Through the CLARA project, if you qualify

    CLARA is an organised screening programme funded by the EU from December 2025 to October 2029, led by the “Carol Davila” University of Medicine with one hospital or institute in each region. It is free for women aged 25 to 65 who live in the region and belong to a vulnerable group: socio-economically disadvantaged people, vulnerable groups, or communities with increased vulnerability. Access is through affiliated family doctors.

    What to do: ask your family doctor whether they are affiliated with CLARA. Your region's centre appears in the calculation above once you pick a county.

  3. A Pap test on a family doctor's referral

    Cytology alone is the older, less sensitive method, but it has a code and a price in the Insurance House list, at laboratories contracted for cytology, and the sample can be taken at the family doctor's practice. If you cannot find a free HPV test, it is better than no test.

At a private laboratory the HPV test costs about 225 lei, and HPV plus cytology about 420 lei (Synevo prices, September 2026).

What “HPV positive” means

It means your cervix carries one of the HPV types that can, over time, change the cells. It does not mean cancer. The virus spreads through sexual contact, it is very common, and in most cases the immune system clears it on its own. Screening looks for the infections that stay.

  1. The cervical sample
    1. HPV test (14 high-risk types)
      1. NegativeNext test in 3 years (25–29) or 5 years (30–65)
      2. PositiveCytology on the same sample
        1. Normal cellsHPV test again after 12 monthsnegative: back to routine · positive: colposcopy
        2. Abnormal cellsColposcopy, biopsy if needed, treatment of the lesion
What follows each result under Romania's national method.

Types 16 and 18 cause more than 70% of cervical cancers. The Romanian method nevertheless treats all 14 types the same way: the decision rests on the cytology and on the retest a year later.

Pick the result you received and see what comes next

The HPV vaccine at your age

Since autumn 2025 the HPV vaccine in Romania has been free for girls and boys aged 11 to 26 (until their 27th birthday). Women aged 27 to 45 (until their 46th birthday) get it 50% reimbursed. A family doctor can write the prescription; you buy the vaccine at a pharmacy and it is given at the practice.

In Sweden, among 1.67 million girls and women followed up to age 31, those vaccinated before 17 had about one eighth as many cervical cancers as the unvaccinated (Lei and colleagues, New England Journal of Medicine, 2020). The effect is largest when the vaccine comes before any contact with the virus.

How many doses you need and how to get the prescription

How far Romania is from the rest of Europe

  1. Romania12.0
  2. EU average3.5
  3. Sweden2.7
Cervical cancer deaths per 100,000 women, age-standardised rate, 2022. Source: Eurostat.

In 2022, 1,290 women died of cervical cancer in Romania and 151 in Sweden (Eurostat, registered deaths). Because the populations differ, the fair comparison is the age-standardised rate per 100,000 women: 12.0 in Romania, 4.4 times Sweden's rate and 3.4 times the EU average.

In 2019, 39% of women in Romania told a survey they had been tested in the previous three years (OECD, 2025). The World Health Organization's target is for 70% of women to be screened with a high-performance test by 35 and again by 45.

Frequently asked questions

Is the HPV test free in Romania?

Yes, if you are insured and have it done by a gynaecologist contracted with the Insurance House for the package of early detection of cervical lesions (with a family doctor's referral), or through the CLARA project if you belong to a vulnerable group. With a family doctor's referral straight to a laboratory, the HPV test has no price in the Insurance House list; Pap cytology does.

How often is the HPV test done?

From 25 to 29, three years after a negative test. From 30 to 65, every five years. After a positive test with normal cytology, 12 months later. If the sample could not be read, three months later.

Up to what age is the HPV test done?

The national method covers women aged 25 to 65. Symptoms (bleeding after sex, between periods or after the menopause) should be reported to a doctor at any age.

What does HPV positive with normal cytology mean?

You carry a high-risk HPV type, but the cells show no changes. You repeat the HPV test 12 months later. If it is positive again, you go for colposcopy; if negative, you return to routine screening.

Do I still need the test if I am vaccinated?

Yes. The method makes no exception for vaccinated women, and the vaccine does not cover every high-risk HPV type.

Is the Pap smear still needed?

Yes, as the second step: it is done on the same sample, only when the HPV test is positive. On its own it is the older method; it remains a free option on a family doctor's referral if you cannot find the HPV test.

Is the HPV vaccine free for adults?

For girls and boys until their 27th birthday, yes. Women aged 27 to 45 pay half. From 15 on, the schedule has three doses.

What is the CLARA project?

An organised cervical screening programme funded by the EU until October 2029, free for women aged 25 to 65 in vulnerable groups. You join through your family doctor, if they are affiliated.

Sources and method

Checked on 27 September 2026. Next check due by 31 March 2027. Responsible for publication: Marius Comper.

This page explains the programme's rules and where to get tested. It does not diagnose and does not replace a consultation.

The programme rules (ages, intervals, the steps after a result) come from the 2024 method. The payment routes come from the National Health Insurance House rules as of January 2026: we looked for the HPV test in the list of tests paid to laboratories and did not find it, unlike cytology; we found it in the outpatient gynaecology packages. There is no public national list of practices contracted for this package, so the steps say what to ask.

The CLARA centres are the project's partner hospitals. For the North-East, North-West, Centre, South-Muntenia and West, the region is confirmed by the hospital or local press; for South-West Oltenia (Craiova), South-East (Constanța) and Bucharest-Ilfov (the “Trestioreanu” Oncology Institute) we matched the partner to the region it is in. Counties are grouped by Romania's development regions.

The calculation starts from your year of birth, so your age may be off by a year. “Skipped” tests are the moments the programme would have called you, counted from 25 or from your last test; the HPV-based method only began in 2024, so they show what today's rules would have scheduled, not a failing of yours.

The comparison with Sweden uses Eurostat's age-standardised rate, not the number of deaths, because the populations differ.

Further reading

Sorana Stănescu writes “Foaia de observație”, a Romanian-language newsletter on how the Romanian health system works in practice. Two of her pieces on screening: “How to check your cancer risk” (January 2025) and “Cancer screening in Romania, a puzzle” (June 2025).

Also in this guide