The first description of malignant cells in the sputum was reported by W.H. Washe. 1 Sputum tests are now performed to screen for lung cancer.
History of Cancer Detection 1851-1995
The first gastroscope, an instrument inserted down the esophagus and used to view and detect cancer in the lower esophagus and stomach, was created by Jan Mikulicz-Radecki.1
The newly discovered X-ray radiograph, or Roentgen picture (named after its discoverer, Wilhelm Conrad Röntgen), was used by Franz Konig, a German surgeon to picture an amputated leg which was determined to contain a sarcoma of the tibia.12 The X-ray quickly became a tool for visualizing and diagnosing tumors inside the body. In 1901, Röntgen won the Nobel Prize in Physics for his work on X-rays.
Bronchoscopy was introduced by Gustav Killian when he removed a piece of pork bone from the bronchus of a farmer. Inspired by his report, Chevalier Jackson constructed the first bronchoscope soon after.12
The first electrocardiogram (ECG) reading was taken by Willem Einthoven using a string galvanometer that he designed himself.1 ECGs can be used to diagnose renal cancer.
A primitive form of intravenous/excretory urography, a procedure used to visualize the upper urinary tract (by injection of contrast material) and diagnose cancer of the bladder, was developed by Fritz Voelcker and Alexander von Lichtenberg.1
- 1. Skrepetis, K., et al. "Controversies About Discovery and Development of Excretory Urography." Journal of Pelvic Medicine & Surgery. 10 (2004): 71-80.
The first colposcope, and instrument that is inserted into the vagina and used to view and detect cancer of the vagina and cervix, was created by Hans Peter Hinselmann.1
The use of x-rays for diagnostic examination of the breast was introduced in by Stafford Warren. His technique involved the patient lying on her side with her arm raised and having the picture taken from the side.1
- 1. Warren, S.L. "A Roentgenologic Study of the Breast." The American Journal of Roentgenology and Radium Therapy. 24 (1930): 113-124.
The Pap smear was introduced as a method of diagnosing carcinomas in the female genital tract by George Papanicolaou.1
Urinary cytology, the examination of cells and other materials in urine, was used by George N. Papinicolaou and Victor F. Marshall to diagnose cancer of the bladder. 1
An early version of the mammogram, comprised of a cone and compression pad apparatus was created by Raul Leborgne to X-ray the breasts. In the paper reporting the device and its use on several patients, he recommends that "roentgen study should now be included in the diagnosis of mammary pathology." 1
Bone scintigraphy, or photoscanning of the bone with a radioactive isotope, using Sr was performed as a diagnostic test for spinal metastases by Gynning et al. 1
- 1. Gynning, I. et al. "Localization With Sr85 of Spinal Metastases in Mammary Cancer and Changes in Uptake After Hormone and Roentgen Therapy: A Preliminary Report." Acta Radiologica. 55 (1961): 119-128.
The first endoscopic retrograde cholangio-pancreatography (ERCP), an endoscopic procedure used to diagnose cancer in the bile ducts and pancreas, was performed by Dr. William McCune. 1
A radioimmunoassay made to detect alpha-fetoprotein, a tumor marker often found in higher concentrations in those with liver and testicular cancer, was created for screening purposes by Ruoslahti and Seppala.1
The computerized tomography (CT) scan was created by Godfrey Hounsfield. CT utilizes X-rays and computer assisted analysis to generate images that represent 'slices' or cross-sections through the target organ(s). CT scans are used to diagnose several different cancers. 1
Magnetic resonance imaging (MRI), which produces computerized images of the body that are used to diagnose several different cancers, was developed by Paul Lauterbur and Peter Mansfield. The imaging is based on the different signals obtained from different tissue types that are subjected to a high magnetic field. 12 In 2003 the developers won the Nobel prize in medicine for their work.3
- 1. Britannica Online. Encyclopedia Britannica. Accessed 13-17 June. 2005 [http://www.eb.com]
- 2. Schnall, M. and M. Rosen, Primer on imaging technologies for cancer. 2006 Jul 10;24(20):3225-33 [PUBMED]
- 3. Rlederer, Stephen J. "MR Imaging: Its Development and the Recent Nobel Prize." Radiology. 231 (2004): 628-631. [PUBMED]
The first human positron emission tomography (PET) scanner, an instrument which creates high resolution computerized image which may be used to diagnose cancer, was built by Michael Phelps and Ed Hoffman. PET imaging is based on the detection of radiation that is released from chemicals introduced into the body. While CT and MRI give good images of anatomical structures they do not tell anything about the biological activity (i.e. cell growth) in the area. PET is able to give information about the biochemical activity of the observed structures. This allows for the discrimination between objects that are non-living such as a scar from a growing group of cells such as those in a tumor.1
A sensitive enzyme immunoassay made to detect Prostate-specific Antigen (PSA), a tumor marker that may be found in higher concentrations in the blood of those with prostate cancer, was created as a possible diagnostic method for prostate cancer by Kuriyama et al.1
- 1. Kuriyama, M., et al. "Quantitation of Prostate-specific Antigen in Serum by a Sensitive Enzyme Immunoassay." Cancer Research. 40 (1980): 4568-4662.
Robert Bast and his laboratory developed an immunoassay to detect the tumor marker CA-125. CA-125 is a glycoprotein that can be detected in the serum of human blood.1 The test assists in the diagnosis of some types of ovarian cancers and is also used to follow up on them.
Detection of Human Papillomavirus (HPV) DNA in cervical cells as a screening tool for cervical cancer was introduced by Ritter et al.1
Sonohysterography, a radioimaging method that is used in diagnosis of cancer of the endometrium and uterus, was developed by Drs. Parsons and Lense. In this technique, fluid is used to expand the uterus and an ultrasound probe is inserted into the vagina1