Australian women are being subjected to far more Pap smears than necessary, according to mounting evidence that one test every three years is enough.
Australians are urged to have the uncomfortable test every two years, but new research shows they do no better than women in England and New Zealand where less frequent screening is recommended.
"The findings are important because they support a large body of international evidence that three-yearly screening is likely to be safe and effective," says University of New South Wales Associate Professor Karen Canfell, co-author of a paper published in the journal Cancer Causes and Control.
New Zealand recommends screening every three years. England has an age-based program, with women under 50 screening every three years and older women every five years.
All three countries had about a 40 per cent drop in cervical cancer deaths in the 10 years after screening started in the mid 1990s, says Prof Canfell, who is taking part in a major review of Australian recommendations and chairs Cancer Council Australia's screening advisory committee.
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Cervical cancer is usually caused by the sexually transmitted human papilloma virus (HPV). The Pap smear, named after the Greek doctor Georgios Papanicolaou, is designed to pick up pre-cancerous warning signs well before cancer develops.
Australia's review is prompted by the introduction of the HPV vaccination, which considerably reduces the risk in young women. There have also have been technological advances, including a test for HPV and improvements to the standard Pap smear.
New recommendations are expected by the end of 2014.
"The bottom line is that this research supports less frequent screening and this perspective is critical to the current review," says Prof Canfell.
She says many women find the test difficult and would appreciate reduced frequency as long as there is reassurance the change is safe.
"We are not encouraging behaviour change at this point.
"All women, whether they have had the HPV vaccine, still need to prioritise cervical screening every two years while a very careful review of the new technologies and recommendations for screening is going on," she says.
