Born: 19 September 1915, Canada
Died: 18 August 1980
Country most active: United States
Also known as: Elizabeth Stern Shankman
The following is excerpted from Infinite Women founder Allison Tyra’s book The View from the Hill: Women Who Made Their Mark After 40.
From the 1920s to the 2000s, the incidence of cervical cancers in the United States dropped by at least 70 percent, thanks in no small part to pathologist Elizabeth Stern. Building on the work of Greek doctor and Pap smear namesake Georgios Papanicolaou (whose wife, Andromache, rarely gets credited for letting him take daily cervical samples from her for over 20 years), she refined scientists’ understanding of what abnormal cells were cancerous, and how advanced they were.
Born in 1915 in Canada, Stern earned her first medical degree at the University of Toronto in 1939 and moved to the United States the next year, doing additional training at the Pennsylvania Medical School and in Los Angeles at the Good Samaritan and Cedars of Lebanon hospitals. She became one of the first specialists in the field of cytopathology, studying diseased cells, and became a professor of epidemiology in the School of Public Health at the University of California, Los Angeles.
Here, Stern researched cervical cancer, which had been a significant killer of women, and not just from the disease itself. Pap smears were quickly adopted when they became available, which sounds like a good thing —early detection of cancers typically improves outcomes. But gynecologists in the 1940s and ‘50s had no way of knowing when abnormal cells became cancerous. It was also a time when treatments were far less refined—many doctors recommended “radical treatment” such as radium therapy and hysterectomies for any patient with abnormal cervical cells (many of which would not have been cancerous). “They assumed that even if some of these [abnormal cells] … would never produce invasive cancers in the woman’s lifetimes, it was safer to view them as true malignancies and treat them accordingly,” writes one historian. One 1940s study found that one in four women who had hysterectomies to “prevent” cervical cancer died from the operation and one in 11 who underwent radiation therapy—which, again, was less developed than it is today—suffered severe side effects, including permanent incapacitation.
So, Stern began investigating the causes and progression of cervical cancer, finding that the normal cells shed from the lining of the cervix go through 250 separate stages of cell progression before they indicate advanced cervical cancer. Her work led to the development of diagnostic techniques and screening tools better able to pinpoint where in that progression abnormal cells belonged. Because cervical cancer has a slow rate of metastasis—how quickly cancer spreads to other body parts—this would significantly reduce the calls for “radical” treatments, now that doctors had an idea of how advanced a particular patient’s case was.
She is also known for publishing in 1963 what is believed to be the first report linking a specific virus—herpes simplex virus—to a specific cancer, cervical. In 1973, she became the first person to demonstrate a clear link between prolonged use of steroid-containing oral contraceptives and cervical dysplasia, which often precedes cervical cancer. She also showed the link between human papillomavirus and cervical cancer, which would eventually lead to my generation (Millennials) and those who followed us having access to a vaccination that would prevent many people from developing cervical cancer (99 percent of cases are linked to HPV). Stern was also an activist, investigating how women accessed clinics and fighting for women’s clinics in low-income areas. She continued working into the late 1970s, while undergoing chemotherapy for stomach cancer, which would unfortunately kill her in 1980.