HPV testRO

The Pap (Babeș-Papanicolau) test

The Pap smear is no longer the first test. It is now the second

Since July 2024 cervical screening in Romania starts with the HPV test. Pap cytology, known in Romania as the Babeș-Papanicolau test, is done on the same sample, only if the HPV test is positive.

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.

One sample, two examinations

One sampling
  1. 1. HPV testlooks for the virus
  2. 2. Pap cytologylooks for abnormal cells, only if the HPV test is positive

The Pap test looks for abnormal cells under a microscope. The HPV test looks for their cause, the virus. Romania's national method explains the choice: the HPV test finds high-grade cell changes more often, and a negative result is reliable enough for the next test to come five years later instead of three.

When a Pap test alone still makes sense

When you cannot find a free HPV test. Cytology has a code and a price in the Insurance House list (48.70 lei), so you can have it on a family doctor's referral at a laboratory contracted for cytology, and the sample can be taken at the family doctor's practice. It is less sensitive than the HPV test, so on its own it is repeated more often: guidelines that still use it, such as the American ones, recommend it every three years.

If your last test was a Pap test, your next one should be an HPV test. The calculation on the main page shows you when.

Where to get it free

  • On a family doctor's referral, at a laboratory contracted with the Insurance House (cytology alone).
  • At a gynaecologist, after a positive HPV test, in the Insurance House extended package, which also covers cytology (244 lei).
  • In pregnancy, in the pregnancy monitoring package, up to 23 weeks and six days.

All the ways the HPV test is free

Frequently asked questions

How often is the Pap test done?

In the current programme it is no longer done at fixed intervals: it is done on the HPV test sample, only when that is positive. On its own, guidelines that still use it recommend it every three years.

Is the Pap test free in Romania?

Yes, on a family doctor's referral at a laboratory contracted with the Insurance House, if you are insured.

What is the difference between the HPV test and a Pap test?

The HPV test looks for the virus behind almost all cervical cancers. The Pap test looks for cells that have already changed. The sample is taken the same way.

I had a Pap test two years ago. What next?

Your next test should be an HPV test, within three years of the Pap test. After a negative HPV test, the interval becomes three years up to 29 and five years after that.

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