Concurrent discoveries of the value of vaginal smears for diagnosis of uterine cancer.

The history of clinical cytology is analyzed in light of the dependence of discoveries upon their cultural environment and past contributions. Simultaneous reports of George N. Papanicolaou and Aurel Babes and their respective originality are compared. Although glorified for saving countless women from death due to uterine cancer, Papanicolaou tried in vain to convey to his peers the importance of a distinct cellular pattern corresponding to cervical intraepithelial neoplastic lesions. The value of this pattern expressing evolutionary steps in the development of cancer at individual cell levels was not appreciated. His terminology was ignored and replaced by histologic diagnoses already familiar to pathologists as well as clinicians. Papanicolaou was the first to describe this pattern, whereas malignant cells in vaginal smears were recognized and used for cancer diagnosis by others before Papanicolaou's work. It is therefore no wonder that the Nobel Prize Committee was at a loss to identify what he discovered.