Your engine manual should tell you what the manufacturer thinks. Having had a blocked heat exchanger leading to the engine overheating, I would recommend every 3 years. It does depend on how hard the water is, the softer will make it slightly longer. The first sign of it becoming blocked is when you see some steam coming out of the exhaust.
Before you start make sure you have some new o-rings. Do not worry about draining the system, just let it drop in the bilge as you remove the heat exchanger. When you dismantle the heat exchanger, note where the o-rings are sited as they are critical when re-assembling. If there is any build up in the heat exchanger, it will probably be at only at one end and half of the tubes. Getting the o-rings in place can be tricky, you must not knick them as the heat exchanger will start to leak. Total time should be under an hour for the first time and probably only half an hour on subsequent servicing.
Fouling affects performance on heat exchangers usually on the raw water side . so remove the channels ( water boxes etc) and if only one pass there will be one at eachend so you can rod out the tubes straight through. U tubes are more tricyk to rod out . As for frequency it depends on whether there is any change in performance best way is a regular visual check by looking a tthe tubes Hopefully the sea water will be on the tube side and the closed circuit on the shell side
next thing is to chcek for leaks in the tubes and at the tube sheet interface . A simple pressure check on both sides will do . look out for signs of corrosion too