- Genetic testing of pap test fluid may be useful to screen for and
make early diagnosis of ovarian and endometrial cancers sooner with
improved patient outcome
- Endometrial cancer is on the rise, particularly in younger women
due to the increasing incidence of obesity
- Gynecological cancers result in
approximately 25,000 deaths per year and are the third leading cause of
cancer associated mortality
of pap testing fluid (PapSEEK) for the presence of 18 gene mutations commonly
associated with ovarian and endometrial cancers and presence of aneuploidy (the
presence of abnormal numbers of chromosomes in cells) could potentially aid in
the earlier diagnosis and treatment of two common gynecological cancers namely
ovary and endometrial cancers.
current study was conducted by a team of scientists from the Johns Hopkins
Kimmel Cancer Center. The findings of the study appear in Science
Translational Medicine journal.
Why Screening Test For Gynecological Cancers Is Important
- As stated previously, endometrial cancers are on the rise and gynecological
cancers are responsible for a majority of cancer related deaths.
- Additionally many of these deaths occur because the cancer has
spread widely even before diagnosis making them incurable.
- Also, costly diagnostic tests often may not distinguish between benign
and cancerous growths leading to unnecessary tests and procedures on the
- This further underscores the
need for screening tests with earlier diagnosis and treatment, with
significantly better patient prognosis, which is the aim of the PapSEEK
than 86,000 U.S. cases of endometrial and ovarian
were diagnosed in 2017. Treatment often involves surgery and,
in some cases, chemotherapy or radiation," said Amanda Nickles Fader,
M.D., director of the Johns Hopkins Kelly Gynecological Oncology Service,
Department of Gynecology and Obstetrics, and a corresponding author on this
‘Pap test fluid does contain cells shed from the ovary and endometrium, and analyzing these cells in the fluid might enable earlier diagnosis of ovarian and endometrial cancers’
for young women who are diagnosed, loss of fertility is common. If we could
detect the cancer earlier using a test like PapSEEK, the potential to achieve more cures and preserve fertility in select
could be realized."
the team have also announced the development of CancerSEEK
, a single blood test that screens for eight cancer
types, as well as UroSEEK
, a test
that detects bladder and upper urinary tract cancer examining cells found in
Methods of the Study
Since the pap test fluid can contain cells shed from the
ovary and endometrium, analyzing the fluid for the presence of these cells
could potentially aid in the earlier detection of cancer changes and
appropriate intervention sooner.
- The team analyzed 1,958 samples
obtained from 1,658 women, that included 658 endometrial or ovarian cancer
patients and 1,002 healthy controls. Some of the women provided both
- Pap brush samples were also got from
382 endometrial cancer patients and 245 ovarian cancer patients.
- The PapSEEK test was found to be
nearly 99 percent specific for cancer, and identified 81 percent of
endometrial cancers (78 percent early-stage cancers) and 33 percent of
ovarian cancers (34 percent early-stage cancers).
- Using a Tao brush, which extends
further into the cervical canal and sampled cells closer to the uterus or
ovaries, improved the sensitivity of the test.
- Testing plasma samples together with
Pap brush samples also increased the sensitivity of the test.
Lucy Gilbert, M.D. MSc FRCOG, director of gynecologic
oncology at McGill University Health Centre, said, "This allows sampling
closer to where the cancers originated. Intrauterine sampling proved
particularly important for increasing the detection of ovarian cancer."
- Of the 123 endometrial cancer
patients who were tested using Tao brush samples, PapSEEK detected cancer
93 percent of the time.
- Of the 51 ovarian cancer patients
studied, 45 percent were diagnosed as positive with PapSEEK. There were no
Tao brush is not commonly used in the United States but is approved by the U.S.
Food and Drug Administration for endometrial sampling.
- When both the plasma and Pap brush
samples were analyzed, the sensitivity for ovarian cancer rose to 63
"Our study therefore
demonstrates the ability to detect endometrial and ovarian cancer using cervical fluids obtained using two
different methods," said Yuxuan Wang, first author on the study.
conclusion this test if it is approved for routine clinical use could lead to
earlier detection of gynecologic cancers in a non-invasive manner with earlier
About Gynecologic Cancers
are several types of gynaecological cancer
to as women's cancers
. The most
common gynaecological cancers are
common types include cancer of the vulva, vagina and fallopian tube.
one is unique, with differing signs, symptoms, and risk factors (things that may increase the chance of
getting cancer). The risk of developing gynecologic cancer increases with age.
It is possible to reduce the risk for some of these cancers. Early diagnosis
and treatment of these cancers gives the best patient outcome.
Some Tips To Reduce Risk of Gynecologic Cancer
- Have regular exercise and maintain a
- Avoid smoking
- Have periodic screening tests (Pap
smear, mammogram) especially if there is positive family history in first
- HPV (human papilloma virus)
vaccination of all girls aged 9-21 years to prevent cervical cancer
- What Can I Do to Reduce My Risk? - (https://www.cdc.gov/cancer/gynecologic/basic_info/prevention.htm)
- About gynaecological cancer - (https://www.guysandstthomas.nhs.uk/our-services/cancer/cancer-types/gynae/overview.aspx)