Pap Smears For More Than The Cervix?

Ovarian and uterine cancer screening may be included in the Pap smear eventually

Ovarian and uterine cancer cells can trickle down to the cervix and show up on a routine Pap smear. In the future, this additional cancer screening may be part of a normal exam.

A recent study tested DNA samples from Pap smear tests of women with uterine and ovarian cancer. The tests were 100 percent accurate at finding uterine cancer and 41 percent accurate at detecting ovarian cancer. No false positives were reported

"Talk to your doctor about Pap smear testing."

Isaac Kinde, MD and PhD student, at The Ludwig Center for Cancer Genetics and Therapeutics at Johns Hopkins Kimmel Cancer Center in Baltimore, MD, led a study about detecting the presence of ovarian and endometrial cancers in DNA from Pap smear tests.

Shannon Westin, MD, Assistant Professor in the Department of Gynecologic Oncology in the Division of Surgery at the University of Texas MD Anderson Cancer Center in Houston, TX, wrote a perspective in support of using routine Pap tests to additionally screen for ovarian and endometrial cancers.

In a Pap smear test, a healthcare professional takes a swab of a woman’s cervix. The swab collects a tissue sample, which gets submerged in liquid, then goes to a lab to be screened for abnormal cervical cells and the presence of the human papillomavirus (HPV).

The cost of a Pap smear runs between $50-$200, but is covered by many insurance plans with no additional co-pay. DNA testing for endometrial and ovarian cancers would add cost to the traditional Pap smear.

Kinde’s team did further DNA testing on Pap smear samples from an ongoing study. They were looking for genetic mutations in the DNA that were consistent with those found in ovarian and endometrial cancers.

For the study, 24 endometrial, or uterine, and 22 ovarian cancer samples were broken down via gene sequencing to identify the mutations specific to all 46 samples.

The Pap smear tests for all 24 endometrial cases correctly identified the presence of endometrial cancer.

The Pap smear test for the ovarian cases was 41 percent accurate.

The team concluded, “These results demonstrate that DNA from most endometrial and a fraction of ovarian cancers can be detected in a standard liquid-based Pap smear specimen obtained during routine pelvic examination.”

Authors noted that none of the non-cancerous samples tested provided false-positives, meaning the tests did not say a sample was cancerous when it was not.

Dr. Westin’s study pointed to cervical cancer as the leader in cancer-related deaths among women in the past century. Now with routine Pap smear screenings for cervical cancer, early detection has changed all that.

Authors go on to say that, in 2012, more than 22,000 women died from endometrial and ovarian cancers in the US.

Authors recommend further studies on larger groups to duplicate these results and develop cost effective ways to implement the DNA testing into routine Pap smear tests.

This study was published in January in Science Translational Medicine.

The study was supported by numerous private and scholastic cancer foundations and the National Colorectal Cancer Research Alliance and the National Cancer Institute.

Review Date: 
January 7, 2013