Evidence-Based Cervical Cancer Screening: The Modern Evolution of the Pap Smear

The Papanicolou screen (“Pap smear”) was developed in 1928 by Dr. George Papanicolaou for the identification of cervical cancers. It became widely known after his publication in 1941 and widely used in clinical practice in the 1950s; it is now the most commonly performed cancer screening test world-wide (1). This has been one of the most successful cancer screening techniques in modern medicine, and in the United States rates of cervical cancer have decreased by almost 80% since the 1950s (2,3). Pap smear screening has been widely embraced by physicians and women alike, and is considered a critical part of the routine health care of women. However, up to 20% of American women do not receive regular Pap smears, and in developing countries without the complex resources required to process and read Pap specimens, screening remains a challenge (4). Among women with cervical cancer in the U.S., at least 60% did not have appropriate Pap surveillance prior to their diagnoses (5).