Is There Potential for Pap Smears in Ovarian Cancer Detection?

There is no standard tool or routine test used to detect ovarian cancer. Until recently, it was stated that a pap smear could not be relied on to detect ovarian cancer--just cervical cancer.

A pap smear, also known as a pap test, is a procedure that involves collecting a sample of cells from the cervix using a scraper and sending them to a laboratory to be examined under a microscope. Analyzing the sample involves detecting any abnormal changes or growths. Ovarian cancer cells may be detected if the cancerous cells travel to the area around the cervix, but this may occur in extremely rare instances.

However, a recent study, published in the journal Science Translational Medicine, proposes that tissue and fluid gathered during a pap smear can help to detect ovarian cancer and endometrial cancer in women who are disposed to genetic testing. What’s more, the new study suggests that a pap smear can be used to detect other gynecologic cancers at an early stage, thus helping to save thousands of lives each year.

“The goal here was to be able to detect these cancers through tumor gene mutations that are present in either the bloodstream or fluid collected from the cervix or vagina. If we could detect the cancers earlier or at a pre-cancerous state, there’s a potential to not only achieve more cures, but to preserve more fertility in many women,” said Dr. Amanda Fader, a researcher involved in the study and director of the Kelly Gynecologic Oncology Service at Johns Hopkins University School of Medicine.

PapSEEK paves the way

Dr. Fader and fellow researchers developed a noninvasive procedure called PapSEEK to pinpoint cancerous cells associated with ovarian cancer or endometrial cancer from additional samples gathered during a pelvic exam. “DNA mutations that have already been identified for specific cancers. We tested cervical fluid samples to look at 18 genes that are highly or commonly mutated in endometrial or ovarian cancer,” said Dr. Fader.

In order to determine the functionality behind PapSEEK, the researchers collected samples from 1,658 women. 1,000 of the women were healthy and placed in the control group, while the other 656 were diagnosed with ovarian cancer or endometrial cancer and placed in the experimental group. The researchers found that PapSEEK accurately identified over 33% of ovarian cancers and 81% of endometrial cancers. The findings increased to 45% and 93%, respectively, when the research team used a Tao brush, a medical instrument, to gather the cell samples. Ovarian cancer detection rates also increased to 63% when researchers performed a DNA Pap test in the sample population alongside the PapSEEK

Confirming the findings will take some more work

Dr. Fader and her colleagues are currently implementing a larger study in order to further validate their findings. They are hopeful that within 2-3 years, they will have enough data on pap smears to put their findings regarding the test into practice. “This is a really early preliminary set of results that looks promising. But there’s still a long way to go to know if this would actually be helpful,” said Debbie Saslow, director of breast and gynecologic cancer at the American Cancer Society. “I’m not saying it’s not promising. I’m just saying it’ll take a lot more work, a lot more time and a lot more women to know if it would be clinically valuable,” she added.

These findings are revolutionary for ovarian cancer detection. Read on to learn more.