DNA from Pap Smears Could Help Detect Endometrial and Ovarian Cancer

1/09/2013

Analyzing DNA from Pap smears could help detect endometrial and ovarian cancer, a new study published Jan. 9, 2013 in Science Translational Medicine reports. OCRF Scientific Advisory Committee member (and former grantee) Doug Levine, MD, was among the authors of the article, which was highlighted on the cover of the journal.

The routine Pap smear, which allows doctors to detect abnormal cells in a woman’s cervix, was recently updated to screen for human papillomavirus or HPV using DNA testing. Isaac Kinde and colleagues suspected that ovarian and endometrial cancers likely shed a few cells that trickle down into the cervix and could possibly be detected in a Pap smear. The researchers piggybacked on the DNA testing approved for HPV and extended it to look for mutations specific to endometrial and ovarian cancer. The test identified all of the endometrial cancers in Pap smear samples from women with endometrial cancer (although this cancer is typically diagnosed early on due to the presence of symptoms like vaginal bleeding), but only captured 40 percent of patients with known ovarian cancer. However, an early screening option may have the most dramatic impact on women with ovarian cancer, which is often deadly and difficult to diagnose. Importantly, none of the normal samples tested with the new technique showed false positives.

Although more work is needed to confirm these results in larger groups of patients, the results are promising. Even if the approach cannot identify every ovarian tumor, it may be able to detect more of them earlier and more accurately than existing methods. A related “Perspective” article discusses the findings.

Read the abstract here.

Article:  I.Kinde, C. Bettegowda, Y.Wang, J.Wu, N.Agrawal, I.-M. Shih, R. Kurman, F. Dao, D.A. Levine, R. Giuntoli, R. Roden, J. R. Eshleman, J. P. Carvalho, S. K. N. Marie, N. Papadopoulos, K.W. Kinzler, B. Vogelstein, L. A. Diaz Jr., Evaluation of DNA fromthe Papanicolaou test to detect ovarian and endometrial cancers. Sci. Transl. Med. 5, 167ra4 (2013).

Commentary:  S. N. Westin, G. B. Mills, A. P. Myers, Repurposing thePap smear: One step closer to gynecologic cancer screening.Sci. Transl. Med. 5, 167ps1 (2013).