Learning from Women’s Health History: The Invention of the Pap Smear

There is ample room for improvement in women’s health. That is extremely clear. Compared to the duration of human history, the timeline for specific and intentional scientific research pertinent to women’s health is fairly short. However, it is important for us to learn from the past to shape the trajectory of future innovations. And sometimes, the most revolutionary methods, like the Pap smear, have the most fascinating origins. 

Cervical cancer was once the leading cause of cancer death for women in the United States. Its drastic decline in incidence and mortality is greatly accredited to the Pap smear, invented by the driven Greek immigrant and renowned physiologist  George Papanicoulaou. He first discovered his smear method in 1916 while conducting experiment research on actual guinea pigs. He realized that he would be able to determine the duration and stages of the guinea pigs’ reproductive cycles by examining their vaginal secretions under a microscope. Inspired by this, he then shifted his research focus to human physiology generally from 1920 onwards. He was particularly intrigued by the possible implications his smear method could have for detecting cervical cancer. 

For roughly eight years, Papanicolaou fine-tuned his ability to differentiate malignant cervical cancer cells from normal ones through working with samples from willing human patients on microscope slides. The initial paper he published of his findings in 1928 did not gain much traction within the scientific community. Fortunately, in 1943, after 15 years of gaining more academic acclaim,  Papanicolaou collaborated with gynaecological pathologist Dr. Herbert Traut in publishing their monumental book Diagnosis of Uterine Cancer by the Vaginal Smear.  This book noted the significant physiological stages of human menstrual cycles, described symptoms of malignancy, and explained how to administer and evaluate what quickly became known as the Pap smear. 

Thanks in large part to this simple and effective test (and subsequent modifications refining the method), cervical cancer, which again was once the leading cause of cancer deaths for women in the United States, is not even in the top 10. Of course, it still continues to impact health in our society. According to the National Cancer Institute, experts estimate that in 2020, there will be about 13,800 new cervical cancer cases and 4,290 deaths in the United States. They conjecture that these new cases will be predominantly due to late detection and current discrepancies in the Pap smear result accuracy. In other words, the Pap smear isn’t perfect. These flaws call for further research and collaboration. 

Though there may be many more lessons we can glean from the invention of the Pap smear, here are three key takeaways: 

1. Female-founded wellness companies can bring women’s health to the front and center. The severity of cervical cancer was overlooked and minimized for far too long. Now that women are the rightful leaders of women’s health advancement, we can be more intentional in addressing these dire issues sooner. 
2. Major problems often have surprisingly simple solutions. Though the Pap smear was a brilliant discovery, it wasn’t a complicated method at all. In fact, its simplicity and accessibility was a huge part of why it made such a major impact in the gynecological field. 
3. Transferable knowledge can come from the most unexpected places. Who would have ever imagined that a method originally meant to determine the menstrual cycle of guinea pigs would evolve into a life-saving test for women across the world. Answers may be hiding in places we might not think of at first, so interdisciplinary collaboration is crucial. 

As women’s health continues to expand as a field and we are all more intentional in prioritizing our sexual/reproductive wellness, may future innovations be made while bearing lessons from history in mind.