Women, do you have a Pap Smear performed every year? If you don’t, did you know that there is up to a forty-five percent chance that your last Pap Smear could have been falsely identified as normal, putting you at risk for developing cervical cancer?

The Pap Smear, developed by George Papanicolaou in the 1940’s, is a sample of cells taken from the cervix, the opening to the uterus, which are sent to a lab that identifies cell abnormalities, typically dark, irregular shaped nuclei in cells. Since the invention of the Pap Smear, the death rate from cervical cancer has dropped seventy percent. Each year, 65,000 women in the United State are diagnosed with pre-cancerous conditions of the cervix, and 14,000 are diagnosed with cervical cancer. Abnormalities of the cervix can result from many things, but the typical cause is the Human Papilloma virus, a sexually transmitted disease that damages the tumor suppressive gene p53, and stimulates epidermal cell growth factor suppressors.

Cytotechnologists, the people who examine your Pap Smear slide, are often paid for the number of slides they go through in a day, which is around one hundred. A practice such as this can produce a false negative (identified as normal when there are abnormalities) rate between 20 and 45 percent. Another reason for false negatives is errors in sampling which occur right there in the doctor’s examination room.

Thanks to the Women’s Health Movement, there has been an increased public commitment and funding for women's health issues and research. Women’s health advocates have formed groups to educate women about their bodies by teaching them how to perform self-cervical examinations, and even to reshape health care institutions such as clinics and labs. Recently there has been a federal law passed called the Lab Improvement Amendment, which makes a lab reexamine a percentage of Pap smear slides which where initially evaluated as negative for abnormalities.

There have even been technological advancements to fix sampling error such as Thin Prep Pap test, as well as advancements in screening techniques such as PAPNET and AutoPap. A take home pap test called MyPap which would have been marketed to minority groups with poor health care and coverage has been shot down by the FDA for providing a false sense of security to women using the product because of its high number of sampling errors. Women’s health advocacy groups have denounced this move because they feel that some detection, though it may be weak, is better than no detection.

Even though the Pap smear has saved many lives, it is still necessary for women especially, to press for better lab technologies and equal access to gynecological care for minorities to eliminate the 4000 deaths a year from completely preventable cervical cancer.

Suggested Readings:
Charlotte F. Muller. Health Care and Gender. NY: Russell Sage Foundation, 1990.

S.B. Ruzek, V.L. Olsen, & A.E. Clarke, eds. Women’s Health: Complexities and Differences. Columbus: OSU Press, 1997.