The Papanicolaou Smear

George Papanicolaou, who was born in Greece, emigrated to the United States in 1913 and joined Cornell University Medical College in New York City. His early research had nothing to do with cancer. He studied the reproductive system of guinea pigs and found that the cells in their vaginal smears changed with the stages of the estrous cycle.

He guessed that smears taken from women might show abnormal, precancerous or cancerous cells in the same way. In January 1928, at a conference in Battle Creek, Michigan, he presented preliminary findings suggesting that cancer cells could be picked out in vaginal smears. Much of the medical community was skeptical, and he kept refining the technique and gathering data.

The method was validated in clinical studies in the early 1940s, after he began working with Herbert Traut, a gynecologist. Their joint monograph, Diagnosis of Uterine Cancer by the Vaginal Smear, appeared in 1943. In May of that year Traut, from the University of California Medical School, and Papanicolaou, from the anatomy department at Cornell, presented the method to the California Medical Association in Los Angeles, and California and Western Medicine published their paper that year.

The appeal of the smear was that it could find cancer at an early, more treatable stage. It spread widely after 1943 and became the core of cervical cancer screening programs around the world, and Christos Avdulla and Ntaniela Tachirai, reviewing the history in 2024, link it to the sharp fall in the incidence of cervical cancer and in deaths from it. The test's success also made cytology a standard diagnostic tool, and Papanicolaou's Atlas of Exfoliative Cytology followed in 1954. He died in 1962.