Newspaper article International Herald Tribune

Using the Familiar Pap Smear to Spot More Kinds of Cancer

Newspaper article International Herald Tribune

Using the Familiar Pap Smear to Spot More Kinds of Cancer

Article excerpt

For the first time, researchers have found genetic material from uterine or ovarian cancers in Pap smears.

The Pap test, which has prevented countless deaths from cervical cancer, may eventually help to detect cancers of the uterus and ovaries as well, a new study suggests.

For the first time, researchers have found genetic material from uterine or ovarian cancers in Pap smears, meaning that it may become possible to detect three diseases with just one routine test.

But the research is early, years away from being used in medical practice, and there are caveats. The women studied were already known to have cancer, and while the Pap test found 100 percent of the uterine cancers, it detected only 41 percent of the ovarian cancers. And the approach has not yet been tried in women who appear healthy, to determine whether it can find early signs of uterine or ovarian cancer.

On the other hand, even a 41 percent detection rate would be better than the status quo in ovarian cancer, particularly if the detection extends to early stages. The disease is usually in an advanced stage by the time it is found, and survival rates are poor. In the United States, for instance, about 22,280 new cases were expected in 2012, and 15,500 deaths. Improved tests are urgently needed. Uterine cancer has a better prognosis, but still kills around 8,000 women a year in the United States.

These innovative applications of the Pap test are part of a new era in which advances in genetics are being applied to the detection of a wide variety of cancers or precancerous conditions. Scientists are learning to find minute bits of mutant DNA in tissue samples or bodily fluids that may signal the presence of hidden or incipient cancers.

Ideally, the new techniques would find the abnormalities early enough to cure the disease or even prevent it entirely. But it is too soon to tell.

"Is this the harbinger of things to come? I would answer yes," said Dr. Bert Vogelstein, director of the Ludwig Center for Cancer Genetics and Therapeutics at Johns Hopkins University in Baltimore, and a senior author of a report on the Pap test study published Wednesday in the journal Science Translational Medicine. He said the genomes of more than 50 types of tumors had been sequenced, and researchers were trying to take advantage of the information.

Similar studies are under way or are being considered to look for mutant DNA in blood, stool, urine and sputum, both to detect cancer and also to monitor the response to treatment in people known to have the disease.

But researchers warn that such tests, used for screening, could be a double-edged sword if they gave false positive results that sent patients down a rabbit hole of invasive tests and needless treatments. …

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