page_title: Georgios Papanikolaou
section_title: Discoveries
hierarchical_section_title: Georgios Papanikolaou / Discoveries
caption_attribution_description: Pap test, Papanicolau stain, 400x. An obviously atypical cell can be seen.
context_page_description: Georgios Nikolaou Papanikolaou was a Greek physician who was a pioneer in cytopathology and early cancer detection, and inventor of the "Pap smear".
  After studying medicine in Greece and Germany, he emigrated in 1913 to the United States. He first reported that uterine cancer cells could be detected in vaginal smears in 1928, but his work was not widely recognized until the 1940s. An extensive trial of his techniques was carried out in the early 1950s. In 1961, he was invited to the University of Miami to lead and develop the Papanicolaou Cancer Research Institute there.
context_section_description: The fact that malignant cells could be seen under the microscope was first pointed out in a book on diseases of the lung, by Walter Hayle Walshe (1812–92), professor and physician to University College Hospital, London, in 1843. This fact was recounted by Papanikolaou.
  In 1928, Papanikolaou told an incredulous audience of physicians about the noninvasive 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. That year, he had undertaken a study of vaginal fluid in women, in hopes of observing cellular changes over the course of a menstrual cycle. In female guinea pigs, Papanicolaou had already noticed cell transformation and wanted to corroborate the phenomenon in human females. It happened that one of Papanicolaou's human subjects was suffering from uterine cancer.
  Upon examination of a slide made from a smear of the patient's vaginal fluid, Papanicolaou discovered that abnormal cancer cells could be plainly observed under a microscope. "The first observation of cancer cells in the smear of the uterine cervix," he later wrote, "gave me one of the greatest thrills I ever experienced during my scientific career."
  The Romanian physician Aurel Babeș made similar discoveries in the cytologic diagnosis of cervical cancer.  He discovered that if a platinum loop was used to collect cells from a woman's cervix, and the cells were then dried on a slide and stained, it could be determined if cancer cells were present. This was the first screening test to diagnose cervical and uterine cancer. Babeș presented his findings to the Romanian Society of Gynaecology in Bucharest on 23 January 1927. His method of cancer diagnosis was published in a French medical journal, La Presse Médicale, on 11 April 1928, but it is unlikely that Papanicolaou was aware of it. Moreover, the two techniques are different in their design. Therefore, although Babeș's publication preceded Papanicolaou's, the design of the Pap test belongs to Papanicolaou since he had already tried it in 1925 in "Women's Hospital". Recent papers have proven that Babeș's method was different from Papanicolaou's and that the paternity of the Pap test belongs solely to Papanicolaou. Despite this, it must be said that O'Dowd and Philipp believe that Babeș was the true pioneer in the cytologic diagnosis of cervical cancer, and in a spirit of recognition and fairness, in Romania, cervical testing is referred to as the Méthode Babeș-Papanicolaou in honor of Babeș.
  At a 1928 medical conference in Battle Creek, Michigan, Papanicolaou introduced his low-cost, easily performed screening test for early detection of cancerous and precancerous cells. However, this potential medical breakthrough was initially met with skepticism and resistance from the medical community. Papanicolaou's next communication on the subject did not appear until 1941 when, with gynecologist Herbert Traut, he published a paper on the diagnostic value of vaginal smears in carcinoma of the uterus. This was followed two years later by an illustrated monograph based on a study of over 3,000 cases. In 1954, he published another memorable work, the Atlas of Exfoliative Cytology, thus creating the foundation of the modern medical specialty of cytopathology.
caption: Pap test abnormal.
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