Women’s Health Forum
DISCUSSIONS IN PAP SMEAR SCREENING, pt. II
At a 1928 medical conference in Battle Creek, Michigan, a Greek-born physician named George Nicholas Papanicolaou introduced a potential medical breakthrough—a low-cost, easily performed screening test for early detection of the cancerous and precancerous cells that lead to deadly cervical cancer. Papanicolaou, the unique appearance of malignant cells in 1923, told an incredulous audience of physicians about the technique of gathering cellular debris from the lining of the vaginal tract and smearing it on a glass slide for microscopic examination as a way to identify cervical cancer. His development of the now-popular “Pap” smear resulted in a historic drop in the incidence of cervical cancer among American women.At the time of his discovery, 26,000 women in the United States were dying each year from cancer of the cervix. The only method of cancer detection subjected women to a painful and expensive biopsy used for microscopic examination of cells. Early detection was rare, and often the symptoms that prompted women to seek medical care were indications of advanced, and often untreatable, cervical cancer.
In ironic contrast to its eventual success, Papanicolaou’s smear initially met with skepticism and resistance from the scientific com-munity. Although the Pap smear was introduced in the late 1920s, nationwide accep-tance and use of the test lagged decades behind until large-scale Pap smear screening studies began in the early 1950s.
Since then, the Pap test has become a regular part of female health monitoring for most of the industrialized world. The effectiveness of the test is evi-denced by the dramatic drop in the incidence of cervical cancer—from the second leading killer of women in America down to number 14.
Unfortunately, 5,000 women still die from cervical cancer each year in the United States, and thousands more undergo invasive treatments, including hysterectomies, as a result of this cancer. Since cervical cancer is highly curable if caught early, the number of deaths per year and the number of unnecessary invasive procedures could drop further as more women demand and gain access to regular Pap screening.
Originally published in Volume 1 Number 1 (1997) of Women's Health Forumalso see DISCUSSIONS IN PAP SMEAR SCREENING, pt. I