# Smear Test and HPV Test in Antalya > Smear test in Antalya: how a smear differs from an HPV test, at what age screening starts and how often it is done. Self-collected samples and the HPV vaccine. Cervical cancer is one of the few cancers that **can be prevented by screening**. Screening does not look for cancer — it catches the changes that come before cancer and makes it possible to treat them. This page explains the difference between a smear test and an HPV test, and at what age and how often screening is done; in Türkiye the Ministry of Health programme recommends an HPV-DNA test every 5 years between the ages of 30 and 65. In Antalya, sampling for smear and HPV tests is done at Op. Dr. Murat Alpay's clinic in Lara. **In short:** A smear (Pap) test is a screening test that looks for changes that come before cancer in cells taken from the cervix. An HPV test looks not at the cells but at the cause, that is, the high-risk HPV types that can lead to cancer; in guidelines, screening with the HPV test alone is the preferred method. The sample is taken by a doctor; for people at average risk, a vaginal sample they take themselves is also acceptable. The HPV vaccine is important for protection but does not replace screening. For what HPV is, how it spreads, whether it clears on its own and what happens after a positive test, see [HPV (Human Papillomavirus)](https://www.muratalpay.com.tr/en/tedaviler/hpv/). ## Why does screening work? Thanks to the screening practices that became widespread in the middle of the 20th century, the rates of occurrence of and death from cervical cancer have **fallen markedly** over the past 50 years. Screening detects the **precancerous changes** that can progress to cancer if they are not treated. In the United States it is estimated that **around 200,000 women** each year need treatment for a precancerous change. Against this, largely because **screening recommendations are not followed**, it was projected that in 2025 there would be 13,360 new diagnoses of cervical cancer and 4,320 deaths in the United States. The problem, in other words, is not that screening is ineffective but that **it is not done**. ## The difference between a smear and an HPV test The **smear (Pap) test** looks at cells: it examines whether there is a change in the cells taken from the cervix. It has been effective in reducing the rates of occurrence of and death from cervical cancer. The **HPV test**, on the other hand, looks not at the cell but at the **cause**: it looks for the presence of the high-risk HPV types that can lead to cancer. The HPV test **is more sensitive** and, when the result is negative, gives **stronger reassurance that there is no cancer**. For this reason **screening with the HPV test alone** (primary HPV screening) has become the **preferred method** in guidelines both in the United States and worldwide. ## How is screening planned? The intervals below belong to the **American Cancer Society (ACS)** guideline. National screening programmes differ between countries. Ask your doctor about your own screening plan. - **Primary HPV screening** is the preferred method, to be done **every 5 years from the age of 25** (ACS 2020). - When the sample is taken from the cervix **by a doctor** and the result is negative, it is recommended that screening be repeated **every 5 years**. How the guidelines reached their present form is also instructive: in 2002 co-testing (HPV plus examination of the cells) every three years was recommended; in 2012 co-testing every five years became the preferred method; and in 2020 primary HPV screening every five years from the age of 25 became the preferred approach. ## Self-collected samples In 2024 and 2025, HPV testing on a sample **collected by the person themselves** from the vagina was approved. With this method **there is no need to use an examination instrument (speculum)**. According to the consensus recommendations published in 2025 and the ACS, which adopted them: - Primary HPV screening on a cervical sample taken by a doctor is **preferred**. - A vaginal sample collected by the person themselves is an **acceptable** option for people **aged 25–65 at average risk**. - If an HPV test on a self-collected sample is negative, it is recommended that it be repeated **after 3 years** (not the 5 years that apply to a doctor-taken sample). It is stated that this approach **may overcome barriers to accessing screening**. But there are two cautions: most of those whose HPV test is positive need **further assessment steps**, and the data on the method's long-term real-world effectiveness **are still limited**. In some higher-risk people a sample taken by a doctor continues to be recommended. ## When is screening stopped? Because of the frequency of cervical cancer seen in women over 65 and inadequate adherence to the criteria for stopping screening, the ACS updated its 2020 guideline. For screening to be brought to an end in a person at average risk: - The primary HPV tests done **at ages 60 and 65** must be negative (preferred), or the tests in which HPV testing and examination of the cells are done together must be negative (acceptable). - If these tests are not available, **three consecutive negative examinations of the cells** done at the recommended interval, the last of them **at the age of 65**, is acceptable. - If testing is done on a self-collected sample, a **3-year interval** should be followed. It is a condition that the last HPV test **not be at an age younger than 65**. **These recommendations are only for people at "average risk".** They do not cover those under follow-up because of a previous abnormal result or precancerous change, those with a history of cervical cancer, those who have had an organ or stem cell transplant, those with HIV infection or whose immune system is suppressed for other reasons, and those exposed to diethylstilbestrol in the womb. Follow-up for these people is planned separately. ## The HPV vaccine The HPV vaccine offers an important opportunity for protection from cancer. According to US data, in the period 2012–2016 an average of **34,800 cancers** a year were attributed to HPV infection. **92% of these (32,100 cases)** — cancers of the cervix, oropharynx, anus, vagina, vulva and penis — are due to the types targeted by the nine-valent vaccine. ### Who is it recommended for? - It is recommended **routinely at age 11 or 12**; vaccination can be started **from the age of 9**. - It is recommended **for everyone up to the age of 26** who has not been adequately vaccinated. - In some inadequately vaccinated adults **aged 27–45** it may be considered **through a shared decision with the doctor**. It is stated that most adults in this age group will not benefit from the vaccine. - The vaccine is not licensed for adults over 45. ### Why vaccinating at a younger age matters The vaccine has been shown to be **more effective at younger ages**: being vaccinated at 12–13 is markedly more effective than at 14–15, which in turn is more effective than being vaccinated in late adolescence and early adulthood. The American Cancer Society encourages recommending the vaccine **from the age of 9 or 10**, stating that routine vaccination between the ages of 9 and 12 would raise on-time vaccination rates and thereby **increase the number of cancers prevented**. No evidence has been found that the protection given by the vaccine decreases over time. ### Is testing needed before vaccination? **No.** Doing a smear or HPV test before vaccination in order to decide whether the vaccine is appropriate **is not recommended**. The recommendations apply to everyone, regardless of behavioural or medical risk factors for HPV infection. ### Pregnancy and breastfeeding In pregnant women HPV vaccination is **postponed until after the pregnancy**; but there is no need for a pregnancy test before vaccination. **People who are breastfeeding can be vaccinated.** **The vaccine does not take the place of screening.** People who have been vaccinated also need to continue following the cervical cancer screening recommendations. ## Frequently Asked Questions ### Which department should I go to for a smear test? For smear and HPV tests you can see an **obstetrician-gynaecologist**. In Türkiye, under the national screening programme for women aged 30 to 65, family doctors and KETEM centres (Cancer Early Diagnosis, Screening and Training Centres) also perform the HPV test. ### Should I have a smear or an HPV test? The HPV test **is more sensitive** and, when negative, gives stronger reassurance that there is no cancer. For this reason screening with the HPV test alone (primary HPV screening) has become the **preferred method** in guidelines. A smear looks at cells, while an HPV test looks for the presence of the virus that can lead to cancer. ### At what age does screening start and how often is it done? According to the American Cancer Society guideline, primary HPV screening is the preferred method, to be done **every 5 years from the age of 25**. If the sample was taken by a doctor and the result is negative, it is repeated every 5 years. **National screening programmes differ between countries**; ask your doctor about your own plan. ### Can I collect the sample myself? Yes, this is now an approved option and **does not require an examination instrument (speculum)**. But a sample taken by a doctor is **preferred**; a self-collected sample is considered **acceptable** for people aged 25–65 at average risk. An important difference: if a test on a self-collected sample is negative, the repeat interval is not 5 years but **3 years**. In some higher-risk people a doctor-taken sample continues to be recommended. ### My HPV test is positive — do I have cancer? No. An HPV test is not a cancer test; it shows the presence of the virus that can lead to cancer. Most of those whose test is positive need **further assessment steps** — this usually means examination of the cells and, where necessary, [Colposcopy](https://www.muratalpay.com.tr/en/tedaviler/kolposkopi/). Your findings determine the next step. ### When can I stop screening? For screening to be brought to an end in a person at average risk, the HPV tests done **at ages 60 and 65** must be negative; it is a condition that the last HPV test **not be at an age younger than 65**. If these tests are not available, three consecutive negative examinations of the cells done at the recommended interval, the last of them at the age of 65, is acceptable. ### At what age should the HPV vaccine be given? It is recommended routinely at **age 11 or 12** and can be started **from the age of 9**. The American Cancer Society encourages recommending it from the age of 9 or 10, because the vaccine is **more effective at younger ages** — being vaccinated at 12–13 is markedly more effective than at 14–15. ### I am over 26 — is it worth being vaccinated? It is recommended **up to the age of 26** for everyone who has not been adequately vaccinated. Between **27 and 45** it may be considered through a **shared decision** with the doctor; but it is stated that most adults in this age group will not benefit from the vaccine. The vaccine is not licensed for those over 45. ### Do I need an HPV test before being vaccinated? No. Doing a smear or HPV test before vaccination in order to decide whether the vaccine is appropriate **is not recommended.** The recommendations apply to everyone, regardless of behavioural or medical risk factors for HPV. ### I have been vaccinated — can I skip screening now? No. **The vaccine does not take the place of screening.** People who have been vaccinated also need to continue following the cervical cancer screening recommendations. ### I am pregnant or breastfeeding — can I be vaccinated? In pregnancy HPV vaccination is **postponed until after the pregnancy**; but there is no need for a pregnancy test before vaccination. **People who are breastfeeding can be vaccinated.** ## Sources 1. Saslow D, Andrews KS, Manassaram-Baptiste D, Smith RA, Fontham ETH — Human Papillomavirus Vaccination 2020 Guideline Update: American Cancer Society Guideline Adaptation. CA: A Cancer Journal for Clinicians 2020;70:274-280. 2. Perkins RB et al. — Self-collected vaginal specimens for human papillomavirus testing and guidance for exiting cervical cancer screening. CA: A Cancer Journal for Clinicians, 2025. Changes made to the American Cancer Society's 2020 screening guideline. 3. Enduring Consensus Cervical Cancer Screening and Management Guidelines Committee (2025) — recommendations on HPV testing with self-collected vaginal samples. The information on this page is based on the national and international guidelines listed above. The page is reviewed whenever those guidelines are updated. ## Practice and Contact Details The information on this page is general. Please speak to your doctor about your own situation. - **Doctor**Op. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology - **Address**Op. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya - **Telephone**0505 351 77 88 - **Hours**Monday – Saturday 09:00 – 18:00 · Closed on Sunday [← All treatments](https://www.muratalpay.com.tr/en/tedaviler/) --- Original page: https://www.muratalpay.com.tr/en/tedaviler/pap-smear-ve-hpv/ Last updated: 2026-10-19 Op. Dr. Murat Alpay — Specialist in Obstetrics and Gynaecology Op. Dr. Murat Alpay Practice, Tekelioğlu Cd. No:51 B Kat:2, Filo Apt., 07160 Muratpaşa / Antalya 0505 351 77 88 · Monday – Saturday 09:00 – 18:00 · Closed on Sunday *This information is for general guidance only and does not replace examination, diagnosis or treatment.*