See, Test, and Treat Is Coming to Tufts Medical Center

For the fifth straight year, Tufts Medical Center will host See, Test, & Treat®, a free cervical and breast cancer screening program, funded through grants from the College of American Pathologists (CAP) Foundation. The event features same-day test results, diagnoses, and follow-up care for uninsured and underserved women ages 21 and older. Dr. Michael J. Misialek, an associate chair of pathology at Newton-Wellesley Hospital and the medical director of the Vernon Cancer Center, attended See, Test, & Treat® at Rhode Island Hospital and filled us in on what it’s like from a doctor’s point of view. Here is his story:

Maria was waiting quietly, with tears slowly rolling down her cheek. She was worried. It was one year ago that her breast cancer had been detected, and she had returned to the same event where her journey started, the annual See, Test, and Treat (STT) program put on by the College of American Pathologists (CAP) at Rhode Island Hospital.

Maria’s daughter, Juliana, while volunteering at a free dental clinic last year, came across a flier advertising STT. It took quite a bit of urging—Maria hadn’t seen a doctor in almost 20 years—but she was finally convinced to attend. Then, the bad news came.

An abnormality was found on her mammogram. This led to a biopsy and diagnosis of breast cancer. Maria’s subsequent treatment included surgery and radiation. But what came out of the nightmare was hope and inspiration. Juliana had saved her Mom’s life.

During STT, pathologists lead a team of volunteer physicians and healthcare professionals who perform pelvic and breast exams, a Pap test with same-day results, a mammogram with same-day or prompt results, and offer connections for follow-up care. Individual sites may layer on additional services to these core activities, such as immunizations, smoking cessation, and healthy eating tips. The recent Rhode Island Hospital event had 175 volunteers including medical students, pathology residents, pathologists, radiologists, gynecologists, technologists, counselors, nutritionists, and community service representatives.

The targeted population for this event is those without insurance, the underinsured or financially-challenged, or those who may be separated from care by financial, geographic, language, and ethnic barriers. STT works to break down these barriers and provide equal access to care.

CAP was awarded a Robert Wood Johnson Foundation grant to examine patient outcomes and engagement in STT. Thus far, the data looks promising.

The Rhode Island event was a hectic, but well-orchestrated. Patients flowed from registration to Pap to mammography. If anything abnormal is found, a gynecologist is available for immediate colposcopy and additional biopsies, or a radiologist may perform a breast biopsy. This is the epitome of synergy with multiple sub-specialties working as one, a single care team that’s accountable and efficient—what healthcare reform is all about.

Afterwards, patients proceed through an area where they learn about various health maintenance issues. They are given a list and check off each station visited, and turn it in for a gift certificate as an incentive. Think of it as a health fair, spearheaded by pathologists, who are no longer behind the scenes, but front and center meeting the patients behind the slides.

“One of our great challenges is to convey the ‘feeling’ of the program, the sense of enjoyment experienced by the women, as well as by all the volunteers,” says Marion Malone, executive director of the CAP Foundation. “It is this feeling that we believe will break down the barriers that prevent these women from participating in the health care system.”

How many women are still out there yet to be found? One thing is certain: The need far outweighs the current capacity. Thus far, there are about six to eight events offered annually across the country. However, CAP maintains a list of interested sites and hopes to do 25 or more each year.

Fortunately, nothing abnormal was found on Maria’s follow-up exams. But through observation and participation in STT, it has become evident to me that there is a lot of work to be done. The patients seen at these events are only a fraction of the vulnerable population in need. The undocumented population is particularly prone to experience disparities in care. Any advertisement for the events must be carefully constructed, because if there’s a mention of registration or a Social Security number, that will typically will deter an undocumented women from attending. Other barriers to care include a lack of transportation or translation services. All of this must be taken into account when holding these events. All are welcome: documented, undocumented, English speakers, and non-English speakers alike.

At the Rhode Island event, 10 percent of women had an abnormal pap smear, and there was also a few cases of HPV infection identified. Breast cancer was discovered in one patient, and hopefully a life was saved in doing so.

Tufts Medical Center, October 25, 8 a.m. to 5 p.m.; 617-636-4872; cap.org