When Dr. Georgios Nikolaou Papanicolaou began developing a test to detect cervical cancer, he relied on his wife to serve as his research subject, because he had no other option at first.
Dr. Papanicolaou, who at 21 completed his medical studies at the University of Athens in 1904, and his wife, Mary, had arrived in Manhattan from their native Greece in 1913 so he could pursue basic science research, a more established field in the U.S. Neither spoke English, and they had little money, so they took any job they could get. Mary worked as a seamstress at the Gimbels Department Store in New York City, and Dr. Papanicolaou was a rug salesman, a violin player at restaurants, and a clerk at a Greek newspaper. A year later, in 1914, he landed a part-time research role in the department of pathology at the former New York Hospital and soon moved to a full-time research position at Cornell University Medical College, in the department of anatomy. There, he commenced his studies on cervical cancer, which, in the early 1900s was the leading cause of cancer deaths in women, claiming nearly 40,000 lives every year.
He would then work at what is now NewYork-Presbyterian/Weill Cornell Medical Center for the next 47 years, retiring as professor emeritus of clinical anatomy, director of the Papanicolaou Research Laboratory, and consultant to the Papanicolaou Cytology Laboratory.
Though the presence of cancer cells in sputum and urine were being researched and studied at that time, the focus on cervical cancer was fairly new. To do the research, Dr. Papanicolaou needed female research subjects.
“At the time, he did not have a physician’s license to practice in the U.S.,” says Dr. Rema Rao, an assistant attending at the Papanicolaou Cytopathology Laboratory at NewYork-Presbyterian Hospital and an assistant professor of pathology and laboratory medicine at Weill Cornell Medicine. “That’s probably the reason his wife was his subject.”
Mary served in this role for the next 10 years, but he later would have opportunities to make observations on patients at the gynecologic clinic at Cornell. Typically at that time, when cervical cancer was diagnosed, the disease had already reached an advanced stage. His goal was to detect it earlier through scraping cells from tissue in the cervix for microscopic examination. According to the National Center for Biotechnology Information, Dr. Papanicolaou had deduced that reproductive cycles in guinea pigs (his earliest test subjects) could be timed by examining smears of their vaginal secretions. When he turned his attention to the human reproductive system, he was able to spot the differences between the cellular biology of normal and malignant cervical cells upon viewing swabs smeared on microscopic slides.
He presented his initial findings in 1928 at the “Third race betterment conference” in Michigan, but they weren’t widely accepted by the medical community. After years of research and relentless pursuit, he continued to publish his breakthrough findings, which ultimately led to the Pap test. It took more than 20 years for his work to be accepted by the medical community.