The future of the Pap test: Identifying endometrial and ovarian cancers

There may one day be another compelling reason for women to undergo the Pap test on a regular basis: It may be used to screen for endometrial and ovarian cancers.

That’s the conclusion of researchers who sought to determine whether the Pap test can be used to detect mutations present in rare tumor cells that are shed from endometrial and ovarian cancers and end up on the cervix.¹ They found that DNA from most endometrial and some ovarian cancers can be found in a standard liquid-based Pap specimen obtained during a routine pelvic exam.

Kinde and colleagues performed their study in four parts:

1. They established the somatic mutations that often are present in endometrial and ovarian cancers
2. They identified one or more mutations in each tumor from 46 women with these cancers
3. They determined whether these mutations could also be detected in Pap specimens from the same patients
4. They developed a technology—which they called the “PapGene test”—that could directly evaluate cells from Pap specimens to determine whether these mutations were present.

Using massively parallel sequencing, they identified these mutations in the DNA from liquid Pap specimens in 100% of women with endometrial cancers (24 of 24 cases) and 41% of women with ovarian cancers (9 of 22 cases).¹

Kinde and colleagues concluded that “PapGene testing has the capacity to increase the use of conventional cytology screening through the unambiguous detection of DNA from endometrial and ovarian carcinomas, and lays the foundation for a new generation of screening tests.”¹

In a summary accompanying the study, the editors of Science Translational Medicine noted that PapGene testing “is not yet ready for clinical use and will not serve as a foolproof method of diagnosing genital tract tumors, particularly ovarian cancer … Importantly, though, the new test has not misclassified any healthy woman as harboring a cancer, raising the possibility of its eventual use as a screening test for cancer. Even if this approach cannot identify every ovarian tumor, it may be able to detect more of them earlier and more accurately than is possible with existing methods.”¹

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