Cervical cancer is one of the cancers for which prevention and screening are particularly effective.
In the vast majority of cases, it is linked to a persistent infection with certain human papillomaviruses, known as high-risk HPV. These infections can gradually cause precancerous lesions of the cervix, which can be detected and treated before they progress to cancer.
In France, organised screening concerns women aged 25 to 65, except in particular situations requiring different follow-up. The test used depends on age: cytology between 25 and 29, then a high-risk HPV test from the age of 30. (Assurance Maladie, 2026)
Why is the papillomavirus at the heart of screening?
Human papillomaviruses are extremely common.
The Assurance Maladie (French national health insurance) estimates that around 80% of adults will be exposed to an HPV infection during their lifetime. Most of these infections clear up on their own. Only a minority persist long enough to cause precancerous lesions.
Screening therefore looks for either:
- abnormalities in the cells of the cervix;
- or the presence of a high-risk HPV likely to persist.
The aim is to identify lesions before they become cancerous, or to diagnose cancer at an early stage.
Which test at what age?
From 25 to 29: cytology
Between 25 and 29, screening relies on cytology, often called a "smear test".
The recommended schedule is:
- a first test;
- a second test one year later;
- then, if both results are normal, a new test three years later.
Cytology looks directly for abnormalities in the cells taken from the cervix.
From 30 to 65: the HR-HPV test
From the age of 30, the reference screening test in France becomes the high-risk HPV test, or HR-HPV test.
It is performed:
- three years after the last normal cytology;
- then every five years when the result is negative.
The HPV test does not look directly for abnormal cells: it detects the presence of high-risk papillomaviruses.
How is the sample taken?
The sample is taken from the cervix during a gynaecological examination.
A speculum makes it possible to see the cervix, then a few cells are collected using a small brush.
The same type of sample can be used:
- for cytology;
- for the HR-HPV test.
The sampling is generally only slightly painful or not painful at all, but some discomfort or a feeling of pressure may be felt for a few moments.
What about vaginal self-sampling?
In certain situations, the HPV test can be performed on a vaginal self-sample.
This method can be particularly useful for people who are far from screening or who have difficulty with conventional cervical sampling.
The scientific data are encouraging, but it is important to be precise: performance depends in particular on the device used and the HPV analysis method.
A systematic review published in 2024 covering 70 studies found that most studies reported diagnostic performance close to that obtained with a sample taken by a professional, with high acceptability.
Other, more recent meta-analyses do however show some heterogeneity and indicate that, depending on the devices and techniques used, sensitivity may be slightly lower than with a sample taken by a professional.
Self-sampling is therefore an interesting option, but its use must follow the arrangements of the screening programme and the validated tests available.
What happens if the HPV test is positive?
A positive HPV test does not mean that you have cancer.
It indicates that a high-risk HPV was detected at the time of sampling.
Most infections clear up on their own. It is above all the persistence of an infection with a high-risk HPV that increases the risk of precancerous lesions developing.
When the HPV test is positive, a cytology analysis can be performed on the same sample to examine the cells of the cervix.
Depending on the result:
- if the cytology shows no abnormality, monitoring is generally offered;
- if cell abnormalities are present, a colposcopy may be indicated.
The exact course of action depends on the cytology result and the applicable recommendations.
What is a colposcopy?
Colposcopy is an examination of the cervix performed with a magnifying instrument.
It makes it possible to observe suspicious areas precisely and, if necessary, to take a biopsy.
The sample is then analysed in the laboratory to determine whether there is a precancerous or cancerous lesion.
Vaccinated against HPV: should screening continue?
Yes.
HPV vaccination greatly reduces the risk of infection with several types of papillomavirus responsible for cancers, but it does not protect against all high-risk HPV types.
Vaccination and screening are therefore complementary.
Even a vaccinated person must continue screening according to the recommendations for their age and medical situation.
And during pregnancy?
Pregnancy does not necessarily prevent cervical screening.
The timing of the sample must however be decided according to:
- the stage of pregnancy;
- previous results;
- the clinical context;
- and the opinion of the professional providing the follow-up.
Screening may be offered during antenatal follow-up or after the birth, when appropriate.
Organised screening and reimbursement in France
Since 2024, the Assurance Maladie has been sending invitations for organised screening to people who have not been screened within the recommended intervals.
Within this programme:
- cytology or the HR-HPV test is covered 100% for people who have been invited;
- the cervical sampling is reimbursed under the usual conditions of the Assurance Maladie.
In 2026, the Assurance Maladie states that the sampling is reimbursed at 70% of the agreed tariff, with the remainder potentially covered by complementary health insurance.
Screening can be carried out by:
- a gynaecologist;
- a general practitioner;
- a midwife;
- or other authorised professionals and facilities, depending on how screening is organised.
When should you consult without waiting for the next screening?
Screening is intended above all for people without symptoms.
Some signs require a medical consultation without waiting for the next screening:
- bleeding after sexual intercourse;
- bleeding between periods;
- bleeding after the menopause;
- unusual vaginal discharge;
- persistent pelvic pain.
In this context, it is no longer simply routine screening: a diagnostic assessment may be necessary.
Particular situations
The standard schedule does not suit every situation.
Different follow-up may be needed in particular in cases of:
- immunosuppression;
- a history of precancerous cervical lesions;
- a history of cervical cancer;
- previous abnormal results.
The Assurance Maladie states, for example, that in cases of immunosuppression, excluding HIV infection, the French National Authority for Health (HAS) recommends closer monitoring: annual cytology between 25 and 29, and an HPV test every three years between 30 and 65 as long as the result remains negative.
Key points to remember
- 25 to 29: screening by cytology.
- First two tests one year apart, then a new test three years later if the results are normal.
- 30 to 65: HR-HPV test.
- The HPV test is performed three years after the last normal cytology, then every five years if it remains negative.
- A positive HPV test does not mean cancer.
- Vaccination and screening are complementary.
- People with certain medical histories or immunosuppression may need different follow-up.
Medical information: this article provides general information and does not replace a medical consultation. The schedule and arrangements for screening may be adapted to your personal situation.
Medical and Scientific Sources
Assurance Maladie. Dépistage organisé du cancer du col de l'utérus (organised cervical cancer screening). Updated 21 April 2026. https://www.ameli.fr/assure/sante/themes/cancer-col-uterus/depistage-organise-cancer-col-uterus
Assurance Maladie. Prévenir le cancer du col de l'utérus : vaccination HPV et frottis de dépistage (preventing cervical cancer: HPV vaccination and screening). 11 May 2026. https://www.ameli.fr/assure/sante/themes/cancer-col-uterus/prevention-cancer-col-uterus
Haute Autorité de santé. Dépistage du cancer du col de l'utérus : le test HPV-HR recommandé chez les femmes de plus de 30 ans (HR-HPV test recommended for women over 30). https://www.has-sante.fr/jcms/p_3192618/fr/depistage-du-cancer-du-col-de-l-uterus-le-test-hpv-hr-recommande-chez-les-femmes-de-plus-de-30-ans
Aimagambetova G, et al. Comparison of diagnostic accuracy and acceptability of self-sampling devices for human papillomavirus detection: a systematic review. Preventive Medicine Reports. 2024;38:102590. PMID: 38283967. https://pubmed.ncbi.nlm.nih.gov/38283967/
Accuracy of HPV Self-Collection Compared with Clinician-Collected HPV Testing and Cytology: A Meta-analysis. 2025. PMID: 40643571. https://pubmed.ncbi.nlm.nih.gov/40643571/
Comparative performance of HPV self-sampling and conventional screening methods: a systematic review and bivariate meta-analysis. 2026. PMID: 42217258. https://pubmed.ncbi.nlm.nih.gov/42217258/
Consult Dr. Yasmine Maazouzi at the Hôpital Privé Beauregard (23 Rue des Linots, Bât. B5 ICOGM, Marseille 13004) for your cervical cancer screening or to discuss a result.