Free tests for women aged 40–49 in Lithuania

Who qualifies, and for what

Two prevention programmes of the National Health Insurance Fund (Valstybinė ligonių kasa, VLK — the body that administers compulsory health insurance in Lithuania) apply to this age band at the same time: the cervical cancer programme, which runs from 25 to 59 years of age and which tests the 35–59 group for high-risk human papillomavirus (HPV), and the cardiovascular disease prevention programme for people aged 40 to 60. From the age of 45 the breast cancer programme joins them; that programme covers women from 45 to 74. This page covers women aged 40 to 49, so within it mammography applies from 45 onwards.

The checks below are free of charge for women covered by compulsory health insurance (PSDF, Privalomojo sveikatos draudimo fondas) who fall into the age group set for the programme and who attend a healthcare institution that has a contract with the health insurance fund. There is no charge for the tests or for the appointment. They are arranged through your family doctor (šeimos gydytojas — the GP you are registered with) or, for the cervical and breast programmes, through a gynaecologist.

What each programme includes

• Cervical cancer programme: a high-risk HPV test and, if the result is positive, a liquid-based cytology smear
• Cardiovascular disease programme: an assessment of risk factors, blood glucose, cholesterol and triglyceride tests, and an ECG
• Breast cancer programme (from the age of 45): a mammogram every 2 years

How to get these checks

• Contact your family doctor (šeimos gydytojas) or a gynaecologist, who will check which programmes you qualify for by age
• The doctor issues a referral to an institution that has a contract with the health insurance fund
• For insured people, there is no charge for the tests or for the appointment under the programmes
• Your doctor will tell you the results; if any result is abnormal, they will refer you for further tests

Other tests worth discussing with your doctor

At this age some women begin to experience perimenopausal changes. In addition to the programme checks, it is worth discussing thyroid (TSH) and iron levels with your family doctor (šeimos gydytojas), who may suggest these tests if you have symptoms such as tiredness.

Why several programmes run at this age

In a woman's thirties and forties the hormonal balance gradually changes, and the risk of cardiovascular disease and of some cancers begins to rise, which is why VLK provides several prevention programmes for this age band at the same time. In the cervical cancer programme, women aged 35 to 59 are tested for the presence of high-risk human papillomavirus (HPV) and, if the result is positive, a liquid-based cytology smear is taken; this makes it possible to pick up changes in the cells long before they could develop into cancer. In the cardiovascular programme, glucose, total cholesterol and triglycerides are tested from the age of 40 together with an ECG — taken separately these indicators do not diagnose disease, but they help the family doctor (šeimos gydytojas) assess the overall picture of risk and, if needed, draw up an individual prevention plan. From the age of 45 the breast cancer programme begins, with a mammogram every 2 years — a scan that can pick up changes too small to feel.

All of these tests are a snapshot of one moment. A normal result does not mean that risk stays the same throughout the period until the next check, and an abnormal result does not diagnose anything by itself — it is the grounds for further tests with a doctor.

When not to wait for a scheduled check

Contact a doctor without waiting for a scheduled appointment if you notice any of the following. In Lithuania the emergency number is 112.

• Unusual vaginal bleeding between periods or after sex
• A new lump, thickening or change in the shape of a breast, whether or not you have reached the age for mammography
• Chest pain, tightness, pressure or heaviness, shortness of breath, or pain spreading to your arm, jaw, neck or back — these can be signs of a heart problem, so do not wait for a scheduled check. If it comes on suddenly or is severe, call 112.
• Unexplained weight loss, long-lasting tiredness or severe abdominal pain