The Power of the Pap

Posted on by DCPC
Photo of Cynthia A. Gelb
Cynthia A. Gelb

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.

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5 comments on “The Power of the Pap”

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    Thank you for this excellent post regarding cervical cancer! As a nurse and public health advocate, I strongly recommend following the CDC’s recommended schedule of vaccines and vaccinating teenage girls and boys against HPV. Getting vaccinated against HPV prevents more than cervical cancer; it can prevent oral, throat and anal cancers as well. People in the U.S. as well as other developed nations take for granted that we have vaccines so readily available considering the journey and sacrifices families overseas must make to get their children vaccinated. The rates of cervical cancer are relatively low in the U.S. when compared to other countries, so taking advantage of the HPV vaccine helps build herd immunity against HPV and lower the incidence of cervical cancer. Both the gardasil and cervarix vaccines have been tested and proven to be safe, effective and necessary in reducing the incidence of HPV related cancers. Thank you for being a public health advocate!

    I understand the basic screening guidelines, but what about DES daughters? I’m told that even with a normal pap, if HPV DNA is found with the HPV co-test a colposcopy is recommended? Is this true?

    Thank you for your question. The cervical cancer screening guidelines provided by major medical organizations apply to women who are at average risk of getting cervical cancer. Women who may have a higher risk of getting cervical cancer, including DES daughters, should talk to their doctors about when they should start screening and how often they should be screened. For more information, please see the National Cancer Institute’s fact sheet on Diethylstilbestrol (DES) and Cancer. If your HPV test is positive, ask your doctor what additional tests you should have or contact the American Society for Colposcopy and Cervical Pathology at 1 (800) 787-7227.

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Page last reviewed: Thursday, June 6, 2024
Page last updated: Thursday, June 6, 2024