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Modified Pap smears provide early detection for two deadly gynecologic cancers

Updated: Aug 27, 2020

PAP SMEARS

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And when they added a blood test to the ovarian cancer screening regimen, they were able to detect that deadly cancer in 63 percent of patients who had it. “Having the possibility to detect these cancers earlier is very exciting,” said Nickolas Papadopoulos, a co-author of the study, which was published last week in the journal Science Translational Medicine. It’s the latest example of how scientists hope to detect cancer earlier and with greater precision by looking in blood and other easily accessible fluids for cells that bear the telltale genetic mutations of cancer. While such “liquid biopsies” have not yet made their way into widespread use, they hold the promise of revolutionizing cancer screening. In January, the same research team presented promising findings in the journal Science on a blood test — called CancerSEEK — that’s capable of detecting malignancies of the liver, stomach, pancreas, esophagus, colon, lung and breast. Also last week, they published findings in the journal eLife on a urine test to detect cancers of the urothelial tract or urinary bladder. .

As a screening test for cervical cancer, the Pap smear has been a staple of gynecologic checkups for more than six decades. It’s named for George Papanicolaou, the physician who first showed that cancerous cells of the cervix could be detected by microscopic inspection. The Pap test has dramatically driven down deaths from cervical cancer, which used to be one of the most common cancers in women. However, the test does a poor job of detecting endometrial or ovarian cancer, which together kill about 25,000 women in the United States each year. Women thought to be at high risk of those cancers are sometimes screened with a blood test that detects an immune system biomarker called CA-125, or with a transvaginal ultrasound that looks for telltale thickening of the uterus’s endometrial wall. But those tests fail to detect many cancers and they send up a lot of false alarms, so they’re frequently not used until a woman complains of symptoms.

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