Cervical cancer screening in Lithuania: who qualifies and how often

Who the programme covers and what it costs

The cervical cancer prevention programme (gimdos kaklelio vėžio prevencinė programa) is intended for women aged 25 to 59 inclusive. The tests are paid for from the budget of the Compulsory Health Insurance Fund (Privalomojo sveikatos draudimo fondas, PSDF) under the programme and the schedule approved by the National Health Insurance Fund (Valstybinė ligonių kasa, VLK). Which test you are entitled to depends on your age group.

What the programme includes

• Cervical cytology smear (citologinis tepinėlis) — for women aged 25–34
• High-risk human papillomavirus test (AR ŽPV tyrimas) — for women aged 35–59
• Liquid-based cytology smear (citologinis tepinėlis skystoje terpėje) — if the AR ŽPV test is positive
• Biopsy (biopsija) — if it is needed to confirm or rule out a diagnosis. It is ordered on indication once the results of the earlier tests are available, within the same VLK programme

How to get the test

• Contact your family doctor (šeimos gydytojas) or an obstetrician-gynaecologist (akušeris-ginekologas) for a referral for the test. They will explain which test applies to your age group.
• Women outside the programme's age range who have symptoms that worry them can also contact their family doctor (šeimos gydytojas): the doctor will carry out the necessary tests and, if needed, issue a referral to a specialist.

What the two tests actually check

Most cases of cervical cancer are linked to long-term infection with high-risk human papillomavirus (AR ŽPV), which can cause changes in the cells of the cervix before any symptoms appear. A cytology smear (citologinis tepinėlis, the Pap test) assesses the appearance of the cervical cells and can show changes while they are still pre-cancerous. The AR ŽPV test detects whether the virus that can cause such changes is present in the body. Because the virus is widespread, and the risk grows with age and the longer someone has been exposed to the virus, for women up to 34 the programme relies on the more frequent cytology smear, and for older women on the less frequent but more sensitive HPV test.

What the results mean

A positive HPV result is not a cancer diagnosis — it indicates an increased likelihood that further monitoring or tests are needed, for example a liquid-based cytology smear or a colposcopy (kolposkopija). A negative result means the next test can wait until the programme's schedule calls for it. The tests cannot say whether changes will turn into cancer, and they do not treat the infection itself — they help to notice changes early, when treatment is simpler and more effective. It is worth discussing the interpretation of results and the next steps with a doctor.

When to contact a doctor

• If bleeding occurs between periods, after sex, or after menopause.
• If there is unusual pelvic pain or changes in vaginal discharge.
• If symptoms are worrying and the scheduled programme test is still some time away — in that case it is worth contacting your family doctor (šeimos gydytojas) sooner.
• If an AR ŽPV result comes back positive or a cytology smear result is unclear — the next steps are worth discussing with a doctor.
• For any of these, contact your family doctor (šeimos gydytojas). In an emergency — for example heavy bleeding that will not stop — call 112, the emergency number in Lithuania.

Lithuanian terms you will see on forms