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Editor,—I found the article by Janet Wilson and Wendy Parsons on behalf of the BCCG, concerning cervical cytology practice in UK genitourinary medicine clinics, comprehensive and reassuring in terms of our practice.1
The final statement “there is therefore no evidence from this study to support the practice of additional smears in the presence of an effective national cytology screening programme” is both justified and a case well made.
The paper calls additional smears “opportunistic” and recognises them as being performed in women less than the age of 20, women with genital warts, and in some who have had a normal smear within the previous 3 years.
The OED definition of opportunity is “favourable, appropriate or advantageous combination of circumstances.”2 There is no evidence to suggest that offering smears in these circumstances fulfils this description. If this is so, then we are depriving women such as teenagers of a valuable health screen and patently this is not the case.
I would like to propose, therefore, that we no longer continue to call these smears “opportunistic” but use the term “unnecessary.”
The recognition of this could be an advance for evidence based practice, help to reduce unnecessary anxiety, and release much needed resources.
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