Dr. Pap's smear: The test and its times

The important role of the screening test created by Dr. George N. Papanicolaou is being recast with the advent of HPV vaccines and testing for this virus.

By Victoria Stagg Elliott, AMNews staff. Sept. 3, 2007.

With new technologies that improve cervical cancer screening and reduce the risk of developing this disease, the changing role of the Pap smear in regard to women's preventive health care is being considered more and more.

"Cervical cytology could still have some role indefinitely, but it's getting to be less and less important," said Ruth Shaber, MD, an obstetrician-gynecologist and medical director of the Center for Healthcare Delivery at Kaiser Permanente's Care Management Institute in Oakland, Calif.

The Food and Drug Administration approved a test for human papillomavirus DNA in 2000. A vaccine to protect against several variants of this virus was given the nod in 2006. With improvements to both of these tools expected soon, the question being asked now is how the Pap smear should be used in light of these advances.

"The future as it relates to Pap smear screening is going to play out in a way that is difficult to predict," said Martin Mahoney, MD, PhD, a family physician and associate professor of oncology at Roswell Park Cancer Institute in Buffalo, N.Y.

This test's past achievements are legion, and its value without doubt. It has been credited with slashing the cervical cancer death rate and becoming the tie that binds many women to their doctors' offices for annual checkups. According to data from the Agency for Healthcare Research and Quality, in 2005 slightly more than 86% of women between the ages of 18 and 64 received one within the past three years, making it the most common cancer screening procedure.