The Power of the Pap

By Cynthia A. Gelb
Former Director of CDC’s Inside Knowledge About Gynecologic Cancer Campaign

On a recent morning, I ran into a former colleague who mentioned that her friend, a very young woman, died of ovarian cancer. While we talked about the sad fact that there is no recommended screening test for ovarian cancer, it occurred to me—not for the first time—that we owe so much to Dr. Georgios Papanikolaou (also known as Dr. George Papanicolaou), the inventor of the Pap test.

According to the World Health Organization, cervical cancer is still a leading cause of death for women around the world—mostly in low- and middle-income countries. However, during the past 40 years in the United States, the number of women dying from cervical cancer has decreased dramatically, largely because of the Pap test.

We have become so used to the routine of getting regular Pap tests, that we take the power of the Pap for granted. But think about it—isn’t it amazing that this cancer screening test helps PREVENT cancer?! (The Pap test finds precancerous changes on the cervix so they can be treated before they ever turn into cancer. It can also find cervical cancer early, at a highly treatable and curable stage.)

The current success of the Pap test is much different from how it was received early on. When Dr. Papanikolaou presented a paper titled “New Cancer Diagnosis” in 1928, explaining that vaginal smears could detect uterine cancer, the medical and scientific community largely dismissed the findings. (At that time, and for many years to follow, medical coding dictated that cervical and endometrial cancers were combined under one term: uterine cancer.) He became discouraged and worked on other studies, until a decade later further research confirmed his original findings: that smear samples led to earlier diagnoses of uterine cancer.

More research followed and around mid-century, increasing numbers of scientists and physicians became believers. The “Pap” test, as it was now called, was finally on its way to becoming widely adopted as a screening exam for cervical cancer. In 1960, the American Medical Association began recommending Pap tests for women. Dr. Papanicolaou died just two years later.

Of course, much has happened since—there are changes in recommendations for when to begin getting a Pap test, how often to have the test, when to have an HPV (human papillomavirus) test, and perhaps the biggest advancement yet: the availability of the HPV vaccine for young people that holds promise for eliminating cervical cancer altogether!

So, in January (National Cervical Cancer Awareness Month) and all through the year, you may want to give a nod to Dr. Georgios Papanikolaou. Hundreds of thousands of women are alive today because of this amazing researcher who changed everything.

Learn more about cervical cancer.