George Nicholas Papanicolaou

1883-1962

Greek-American Physician

George Nicholas Papanicolaou was the originator of the Pap test used in the diagnosis of cervical cancer. Papanicolaou's test (known as a Pap smear) became the most effective cancer prevention method ever devised.

Papanicolaou, born in Greece, undertook his medical training at the University of Athens, where he earned his medical degree in 1883. After serving in the army, he joined his father's medical practice for awhile before pursuing a career in academic medicine. In 1910, Papanicolaou earned a Ph.D. degree in zoology from the University of Munich, and moved on to participate in a long oceanographic expedition. When the Balkan War broke out, Papanicolaou once again served his country in the Medical Corps. In 1913—with a new wife and no firm prospects—Papanicolaou set sail for America.

After working briefly as a salesman in a department store and playing the violin in restaurants, Papanicolaou secured a research position at Cornell Medical College, where he quickly rose to the rank of instructor. Papanicolaou's early work studied the role of chromosomes in sex determination. During these studies Papanicolaou noted cyclical changes in various vaginal discharges from test animals that Papanicolaou linked to the ovarian and uterine cycles. Papanicolaou's findings were of great benefit to the fledgling field of endocrinology. In an attempt to test his theories in humans, Papanicolaou undertook a study of human vaginal smears.

During his research Papanicolaou observed that smears from women who had been diagnosed with cervical cancer showed cellular abnormalities (enlarged, deformed, or hyperchromatic nuclei). In 1939, Papanicolaou and clinical gynecologist Herbert F. Traut published a paper titled Diagnosis of Uterine Cancer by the Vaginal Smear. Papanicolaou and Traut argued that cancerous cervical lesions could be detected by observable and measurable cellular changes while the cells were still in a preinvasive phase. Accordingly, Papanicolaou's diagnostic technique made it possible to diagnose asymptomatic patients. Moreover, such early diagnosis enabled physicians to treat patients while they were still in the earliest, and most treatable, stages of cancer. Papanicolaou's findings meant that cervical cancer could be detected and treated before it could metastasize to other sites. The paper and the Pap test proved to be a fundamental milestone in the treatment of a deadly cancer in women.

Ultimately, the Pap smear became a routine, clinical diagnostic test. The Pap smear for cervical cancer was designed as an inexpensive screening test. The idea was that the test should be repeated frequently. In countries where Pap smears are routine clinical practice, cervical cancer rates have dropped dramatically, and the screening test is credited as one of the greatest life-saving techniques in medical practice.

Other diagnostic tests based upon Papanicolaou's methodology (exfoliated cytology, the scraping, staining, and examination of cells from the test site) proved effective in screening for abnormalities in cells from other organs and systems.

Papanicolaou's colleagues often cited Papanicolaou's strict work regimen as evidence of his meticulous dedication to science. Despite success and acclaim, Papanicolaou continued to work at least six days a week and went years between vacations. After nearly a half-century of research at Cornell, Papanicolaou retired with his beloved wife to Florida. Even in retirement, Papanicolaou proved restless: shortly before his death, he founded the Papanicolaou Cancer Research Institute in Miami.

BRENDA WILMOTH LERNER