Department of Pathology

See Test & Treat®: Montefiore Provides Free Cancer Screenings to Underserved Women

Kaneku
Pathology resident Dr. Hugo Kaneku explains the difference between healthy and abnormal cervical cells to a participant at Montefiore's recent See Test & Treat® event.

 

On Saturday, May 30, 2015, a dedicated volunteer team of Montefiore pathologists and clinicians from the departments of Obstetrics & Gynecology and Radiology provided free cervical and breast cancer screenings to over 40 underserved women ages 21 to 64 at the annual See Test & Treat® program, held at Montefiore Advanced Imaging, part of the Moses Division of Montefiore Medical Center in the Bronx. 

Each participant, the majority of whom lacked health insurance, received a pelvic exam and Pap test to screen for cervical cancer and a breast exam along with a mammogram to screen for breast cancer.  By also providing same-day test results, access to insurance options, and connections to follow up services, including primary care, the program helped to eliminate the many barriers to care that underserved Bronx women face. 

Barriers to care

“Too many women in the community that Montefiore Medical Center serves face high hurdles just to access basic preventive care,” said Dr. Michael Prystowsky, professor and chairman of the Department of Pathology. “If these women can have regular screenings and opportunities to learn more about their risks, then we can detect cancers earlier, when the potential for survival is greatest.”

Dr. Mark Einstein, professor and vice chair for research for the Department of Obstetrics & Gynecology and Women’s Health stated, “There are a number of social determinants and barriers to care that women face.  Many of them have little to do with their medical issues.  It is a privilege and our job to work with our community to overcome these barriers to the most basic of preventative care."

One such patient was Rosie, a 40-year-old Grand Concourse resident who recently found a lump in her right breast.  Like many in the immigrant community, she had not seen any doctor since arriving from the Dominican Republic with her three children in 2008. “If I feel sick, I buy medicine over the counter or take my friend’s medications,” she said through a translator.  For Rosie, and many busy women who are raising families, there is no time for preventative healthcare.  Because of this, sometimes screening-preventable diseases get missed and patients later present with advanced disease.

Learning opportunities

The See Test & Treat® program, which is funded by a grant from the  College of American Pathologists (CAP) Foundation, also provided valuable educational opportunities to patients as they waited for their results.  Pathology residents Lauren McLemore, Evan Himchak, Gloria Ramos-Rivera, Ritu Gupta, Jose Mantilla and Hugo Kaneku were on-hand throughout the day to answer patient’s questions, in both English and Spanish.  Sitting at one end of a dual-headed microscope, Dr. Kaneku explained the difference between healthy and abnormal cervical cells to a 43-year-old Bronx resident who lives in a homeless shelter, as she waited for the results of her Pap test.  The two-hour test result turnaround was made possible by a team of cytotechnologists, the primary screeners of the Pap specimens, who decide which Paps are normal, and which are abnormal, requiring further review by the pathologists. "In this way, they function on the 'front lines' of cervical cancer detection," said Dr. Mark Suhrland, professor of Pathology and directory of the Cytopathology Fellowship program.

Guillermo Rodriguez, a representative for State Senator Gustavo Rivera (D-Tremont), stood nearby as Dr. McLemore answered a patient’s question on what age to have her child vaccinated for Human Papillomavirus (HPV), the virus that causes all cervical cancer.   Rodriguez said the See Test & Treat® program was a welcome service in the Bronx, the borough that has the city’s highest incidence of cancer, obesity and diabetes. “Many immigrants live in fear and don’t understand the health care system,” he said.  “Anything we can do to improve health care in the Bronx is urgently needed.”

prystowsky and Himchak
Pathology chairman Dr. Michael Prystowsky and resident Evan Himchak at the recent See Test & Treat® event.

In addition to free testing, educators from the Bronx. Oncology Living Daily (BOLD), Bronx Community Health Network, SHARE, and Ridgewood Savings Bank were also on-hand to explain various free and low-cost health care and financial services available to the low-income and underserved populations.

While most participants went home with a clean bill of health,  Dr. Harriet Smith, professor of Obstetrics & Gynecology and Women’s Health, said several of the patients she saw throughout the day had suspicious lumps and abnormal pap tests. Some had symptoms of other ailments, including one patient who had a third-degree burn on her abdomen and advanced symptoms of diabetes, and most of the patients were uninsured. “It was heart-breaking,” Dr. Smith added. “We are so glad we can help them get the care they need.” 

Prevention is key

More than 12,000 women in the United States are diagnosed with cervical cancer every year, and the incidence of both cervical and breast cancer among minority women is higher than that of the general population. To that end, Dr. Prystowsky stressed the importance of providing access to free preventative care to the underserved population. He said, "See Test & Treat® offers a coordinated, same-day approach to care for these women, and more, it builds a sense of community as women grow comfortable with accessible resources in the neighborhood.” 


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