DNA ANALYSIS OF PAP-TESTS MAY DETECT ENDOMETRIAL AND OVARIAN CANCERS 

Hello. I'm Dr. Maurie Markman from the Cancer Treatment Centers of America in Philadelphia. I want to briefly discuss a very interesting paper that appeared in the January 2013 issue of Science Translational Medicine, entitled "Evaluation of DNA From the Papanicolaou Test to Detect Ovarian and Endometrial Cancers."^[1]

This is a very provocative study in which the investigators looked at a group of women who had been documented to have endometrial or ovarian cancer and for whom they had material from liquid Pap tests. The investigators looked at the material from liquid Pap tests and the cancers to see if there were molecular abnormalities present in the cancers that might have been discovered within the material from the Pap test itself.

In fact, essentially 100% of the endometrial cancers were able to be documented. The material was documented to have molecular abnormalities present within the endometrial cancers themselves and in approximately 40% of the ovarian cancers. One could find a molecular abnormality that is present in the ovarian cancer, and that same abnormality is found in cells present in the liquid Pap test.

Of greater interest, perhaps, is that when the investigators blindly looked at specimens that were either the cancers themselves or normal controls, they were able to find the cancers or document abnormalities in 100% of the cancers that they looked at. No false positives were found in the normal controls.

I must emphasize that this study had a very small sample size and very preliminary analysis, but the data are obviously very provocative and suggest the possibility that material looked at for molecular and genetic abnormalities within routine liquid Pap tests might be used at some point as a screening strategy for the detection of endometrial cancer and, more relevantly because of the difficulty of detecting the disease early, ovarian cancer. In addition, it is theoretically possible that these abnormalities may be detected years before a diagnosis is made, or at least prior to a time when the cancer has metastasized and is truly an early-stage disease, when treatment can be curative with the removal of the malignancy.

Again, this is a very early report but it has very provocative data. I would encourage anyone interested in this area to read this paper. Thank you for your attention.