Georgios Papanikolaou

Georgios Papanikolaou was a Greek medical doctor and researcher who is best known for his invention of the Pap smear, a screening test used to detect cervical cancer. He was born on May 13, 1883, in Kymi, Euboea, Greece. Papanikolaou studied medicine in Athens and later moved to the United States to pursue his career. He conducted extensive research on the female reproductive system and developed the Pap smear in the 1920s. His groundbreaking discovery revolutionized the early detection and prevention of cervical cancer, saving countless lives worldwide. Papanikolaou passed away on February 19, 1962, in New York City, United States. He is buried in Woodlawn Cemetery in the Bronx. His contributions to the field of medicine continue to have a lasting impact, and he is remembered as a pioneer in cancer screening and prevention. In 1914, Papanikolaou and his wife worked at the Department of Anatomy at the Cornell Medical College of Cornell University and contributed to the histological and physiological changes associated with the oestrus cycle in the guinea pig.[16] In 1917, Papanikolaou along with Charles R. Stockard demonstrated that, in the guinea pig, the histologic cyclic changes that occur in the reproductive tract during the estrus cycle also occur in the vaginal mucosa and can be detected by cytologic examination of vaginal smears.[17] This technique (termed the Papanicolaou technique[17]) was groundbreaking and also facilitated the discovery of an ovarian hormone.[17] Papanikolaou then began examining the human reproductive system. His wife Mary, was a crucial partner in this research. She was working in the same laboratory as an unpaid laboratory technician. Every day Mary provided a vaginal sample for the research. She also prepared her own samples in the laboratory for further analysis. She provided daily samples for twenty-one years, eventually encouraging her friends to also provide samples for the research.[18] In 1920, Georgios Papanikolaou realized that he could tell the difference between normal and malignant cells on the cervix by viewing smears on a slide under a microscope.[16] In 1925, with funds from the National Research Council and the Maternal Health Committee, Papanikolaou recruited 12 hospital staff volunteers, together with a number of pregnant gynecological and surgical patients, for a systematic study of cervical cell morphology. The participants were regurarly tested to determine normal hormonal changes and to diagnose early pregnancy.[19] Upon examination of a slide made from a smear of one of the participant's vaginal fluid, Papanikolaou discovered that abnormal cancer cells could be plainly observed under a microscope. "The first observation of cancer cells in the smear of the uterine cervix," he later wrote, "gave me one of the greatest thrills I ever experienced during my scientific career."[19] In 1928, Papanikolaou told an incredulous audience of physicians about the noninvasive technique of gathering cellular debris from the lining of the vaginal tract and smearing it on a glass slide for microscopic examination as a way to identify cervical cancer. That year, he had undertaken a study of vaginal fluid in women, in hopes of observing cellular changes over the course of a menstrual cycle. In female guinea pigs, Papanicolaou had already noticed cell transformation and wanted to corroborate the phenomenon in human females. It happened that one of Papanikolaou's human subjects was suffering from uterine cancer. At a 1928 medical conference in Battle Creek, Michigan, Papanikolaou introduced his low-cost, easily performed screening test for early detection of cancerous and precancerous cells. However, this potential medical breakthrough was initially met with skepticism and resistance from the medical community. Papanicolaou's next communication on the subject did not appear until 1941 when, with gynecologist Herbert Traut, he published a paper on the diagnostic value of vaginal smears in carcinoma of the uterus.[20] This was followed two years later by an illustrated monograph based on a study of over 3,000 cases. In 1954, he published another memorable work, the Atlas of Exfoliative Cytology, thus creating the foundation of the modern medical specialty of cytopathology.[21] The complete works of Papanicolaou as the founder of exfoliative cytology include 5 books and 158 original articles, all of which are summarised in his monographs.