New York. Although the Pap smear has spurred a sharp decline in cervical cancer deaths since it was introduced more than 50 years ago, the test may not pick up one particular type of cervical cancer, new research suggests.

Since 1973, the incidence of adenocarcinoma of the cervix has increased 30 percent, despite a steep decline in a more common form of cervical cancer known as squamous cell carcinoma, researchers reported. While squamous cell cancer arises from the lining of the cervix, adenocarcinoma forms in cervical glands, making it harder to detect. The fact that adenocarcinoma is becoming more common suggests that screening methods for cervical cancer may be insufficient, researchers reported in the August issue of Gynecologic Oncology.

Harriet Smith, MD, of the University of New Mexico Health Sciences Center in Albuquerque, led the study.

Looking at federal cancer statistics, Smith’s team found that the incidence of all cervical cancers fell 37 percent between 1973 and 1996. The incidence of squamous cell cancer dropped 42 percent. In contrast, adenocarcinoma jumped 30 percent. This increase shows that available screening methods may be "insufficient to detect a significant number of lesions that are precursors to invasive cervical adenocarcinoma," the researchers reported. Better methods that target cervical glands are needed, Smith and her colleagues concluded.

"Additional techniques need to be investigated to improve the sensitivity and specificity of the Pap smear," Smith said in a statement. "For example, liquid-based cytology, such as Thin Prep, may be more accurate than the traditional Pap smear in detecting endocervical cells."

However, Smith said, "[Women] should know that in almost all cases, cervical cancer is a preventable disease. Having regular Pap tests and compliance with follow-up of an abnormal test virtually guarantees that no woman has to die from this disease."

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