Cervical cancer screening
For women aged 20 and over, cervical cancer screening is a service provided by the SBK
Cervical cancer is a malignant cancer of the cervix that primarily occurs in the area of the external cervical os. The earlier changes to the cervix are detected, the better. So go for regular check-ups at your gynaecologist's practice. We will be happy to advise you on which examinations are available as part of statutory early detection and beyond. Find out more about these services here on our pages. That way, you can decide for yourself whether you wish to use them.
Eligibility for cervical cancer screening
A woman's age determines which cervical cancer screening service can be used and at what intervals. All women aged 20 to 65 are invited by SBK to attend cervical cancer screening at five-year intervals.
The following services are available to women free of charge as part of the statutory screening programme:
| Type of examination | What the examination involves | Age | Examination interval |
|---|---|---|---|
| Clinical examination | Medical history, inspection of the genital skin regions, bimanual gynaecological examination, examination of the vagina and cervix using a speculum, consultation. From the age of 30, a clinical breast examination is also performed. | Women aged 20 and over | Annual |
| Cytological examination (Pap smear) | Smear from the cervix and laboratory analysis of the material for cell changes, consultation | Women aged 20 to 34 | Annual |
| Co-testing (Pap smear and HPV test) | Smear from the cervix and laboratory analysis of the material for cell changes, HPV test, consultation | Women aged 35 and over | Every three years |
How high is the risk of developing cervical cancer?
Each year, around 4,600 women across Germany develop cervical cancer. Approximately 1,600 women die from it each year. A woman's risk of developing the disease is significantly influenced by her age, whether she attends screening and whether she is vaccinated against HPV.
Of 1,000 women who do not attend screening and are not vaccinated against HPV, the following number will develop the disease over the next 10 years:
| Age | Frauen |
|---|---|
| 20 years | fewer than 1 |
| 30 years | 1 |
| 40 years | 5 |
| 50 years | 9 |
| 60 years | 8 |
| 70 years | 6 |
The services in detail
Find out more here about the individual components of statutory cervical cancer screening.
[Translate to Englisch:] Die klinische Untersuchung in der gynäkologischen Praxis The clinical examination at a gynaecological practice can be used free of charge once a year by women aged 20 and over.
At the start of the clinical examination, your gynaecologist will ask you about any abnormalities or symptoms as part of a medical history consultation. They will also examine the skin in the genital region for changes, such as rashes or other abnormalities.
In order to detect any pathological changes in the internal organs, a bimanual examination is then carried out. During the examination, the gynaecologist palpates the organs through the vagina and from the outside. In this way, the vagina, cervix and uterus, fallopian tubes and ovaries, as well as the bladder, can be examined for their position, mobility, consistency and any sensitivity to pain.
After this, what is known as the speculum examination is carried out. The speculum is an instrument used to dilate the posterior and anterior vaginal walls. For the examination, it is inserted into the vagina and the vaginal walls are dilated. This gives the doctor a sufficient view to examine the tissue of the vagina and cervix for changes. During the speculum examination, it is also possible to carry out the Pap smear or co-testing.
In women aged 30 and over, the clinical examination also includes a clinical examination of the mammary glands and the surrounding lymph nodes, as well as an assessment of the regional skin for changes. In addition, your gynaecologist will show you how to examine your own breasts for abnormalities. You can find out more about breast cancer screening on the
Women aged 20 to 34 are entitled to a free annual Pap smear.
The Pap smear is a cytological test procedure in which cell material from the tissue of the cervix and the cervical os is examined for benign and malignant changes.
For this purpose, cell material is taken during the speculum examination using a spatula and a brush. This smear is fixed onto a slide and sent to a laboratory for analysis. The findings are assessed using a five-level scale: the levels of the scale range from "normal" (Pap I) to "malignant carcinoma" (Pap V).
Your gynaecologist's practice will inform you if the smear has produced an abnormal result. Depending on the level of the finding, further examinations may be necessary, for example a follow-up smear, an HPV test or a colposcopy (examination of the vagina and cervix using a special microscope).
Women aged 35 and over benefit every three years from what is known as combined testing (co-testing), which comprises a Pap smear and an HPV test.
In the HPV test, the cell material taken from the cervix and cervical os is additionally examined for the presence of human papillomaviruses (HPV). All high-risk HPV types are taken into account. There are other HPV types as well, but these cannot cause cancer and are therefore not dangerous.
Carrying out both tests increases the informative value and accuracy of the screening, so that examination intervals of three years are sufficient as long as there are no critical findings. If abnormalities are found, the gynaecologist decides on a case-by-case basis which further tests or examinations are necessary, for example a repeat co-test or colposcopy (examination of the vagina and cervix using a special microscope).
Which costs does SBK cover?
The annual examination at a gynaecological practice is free of charge for women aged 20 and over.
