It's been a clear message to women for decades: get an annual gynecological exam and a Pap test to screen for cervical cancer. Since the development of the Pap test in 1941 by Dr. George Papnicolaou, deaths from cervical cancer have dropped more than 70 percent, making it the most effective cancer-screening tool yet created. The message reached so many women that regular gynecological checkups became the standard in this country, saving millions of lives. But recently, vaccines targeting viruses that cause cervical cancer and new recommendations for less-frequent screening for certain subsets of women have muddled that critical message. In one recent study of 351 patients at a New Jersey family health center, more than half of all women surveyed indicated that they really didn't understand what a Pap test is for. There's also disturbing new evidence that poor women continue to have significantly higher rates of cervical cancer than other women, primarily because they're not getting regular screenings and not following up when Pap test results indicate possible malignancies.