In most cases cervical cancer is a relatively slow-growing cancer. It usually takes about ten years to go through its pre-cancerous to invasive cancer so having a pap smear every couple of weeks is unlikely to give more information than every couple of years.
The Cervical Cancer Prevention Taskforce made some recommendations in November 1991. Most doctors will now be guided by these.
The first smear. Women who have ever been sexually active should begin having screening pap
smears between 18 and 20 years of age, or one to two years after first sexual intercourse, whichever is later.
Subsequent smears. The Taskforce has recommended that screening smears should be taken at intervals of two years until the age of 70, when they can cease if there have been no abnormal smears in the last five years. Women over 70 who have never had a pap smear should be offered one.
Two years has been chosen as an interval for many reasons. It has been found that two-yearly screening picks up the vast majority of women with cancerous and pre-cancerous lesions. Screening women every year does not significantly improve the pick-up rate (93.5 per cent reduction in cumulative incidence of cervical cancer with yearly screening, compared with 92.5 per cent for two-yearly), despite the enormous increase in resources and cost.
Of course, if women have had abnormal smears, the interval between smears should decrease, according to the degree of abnormality. Some women prefer to have yearly smears, despite a record of no abnormality, and most doctors will oblige.
Women who have symptoms, such as abnormal bleeding, or an unusual looking cervix should have investigation, even if routine pap smears are negative.
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