Cervical cancer is one of the most preventable cancers in the United States because of well-established screening protocols; availability of a vaccine against its etiologic agent, human papilloma virus (HPV), and highly effective treatment of pre-invasive disease.

Although implementation of the HPV vaccine is a long-term priority which will eventually reduce multiple types of HPV-associated cancer, major gains in the reduction of cervical cancer are predicted to occur after 2050. Until then, cervical screening through papanicolaou (Pap) testing and HPV DNA testing will continue to be important for the early identification of disease. In 2015, an estimated 12,900 new cases of cervical c...

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Need: Cervical cancer is one of the most preventable cancers in the United States because of well-established screening protocols; availability of a vaccine against its etiologic agent, human papilloma virus (HPV), and highly effective treatment of pre-invasive disease.

Although implementation of the HPV vaccine is a long-term priority which will eventually reduce multiple types of HPV-associated cancer, major gains in the reduction of cervical cancer are predicted to occur after 2050. Until then, cervical screening through papanicolaou (Pap) testing and HPV DNA testing will continue to be important for the early identification of disease. In 2015, an estimated 12,900 new cases of cervical cancer will be diagnosed in United States, and 4,100 women will die of the disease. In the state of Texas, 1,240 new cases will be diagnosed, making it one of the states with the highest incidence rates in the nation. There are significant disparities in the incidence of disease, with the majority of cases occurring among the racial/ethnic minorities.

Similarly, there are significant disparities in the incidence of breast cancer (4), with the highest rates among African American women. Early detection of breast cancer is possible through mammography. The American Cancer Society recommends mammography every 2 year for women over age 50 years. However, mammography utilization is low among low-income ethnic minorities.

The See, Test & Treat® Program of the College of American Pathologists (CAP) is an innovative strategy to provide comprehensive cervical and breast cancer screening for underserved individuals. It leverages the expertise of pathologists, OB/GYN, family practitioners, nurses, and volunteers to provide free cancer screening, diagnostic follow-up, and treatment to medically at-risk women who are faced with financial, linguistic, social, and cultural barriers to health care.

See, Test & Treat® Program is unique in that each program is organized so women receive screening, results, and a connection to follow-up or treatment in one day and is offered in the local community. Thus, it overcomes barriers to diagnostic follow-up and treatment, which often impede medically underserved women from receiving appropriate cancer care. We hypothesize that offering breast and cervical cancer screening, education, and outreach to uninsured women in urban areas of Houston, we will decrease the stage of presentation of disease compared to historical controls without screening.

We are proposing to utilize the See, Test & Treat® Program (STT) as a platform to provide comprehensive cervical and breast cancer screening for underserved individuals in Harris County. Additionally, we will aid participants in establishing a medical home and provide educational outreach to improve public understanding about cervical cancer screening guidelines, abnormal Pap results, and the important role that pathologists play in patient care. Finally we will provide patient navigation services to facilitate education, understanding results of testing, assistance with implementation of any additional treatment patients require, and an opportunity to access additional financial assistance and health insurance available in the surrounding area. Our selected population for this program represents an underserved community with limited access to medical care.

Specific Goals: Specific Goal 1: Implement the See, Test & Treat® Program to provide no-cost Cervical and Breast Cancer screening to 100 medically-underserved women ages of 21-65 in November 2016. Specific Goal 2: Education and Training.

Through providing long term funding to the See, Test & Treat® Program in collaboration with the Houston Methodist and University of Texas Health Science Center at Houston (UT Health), we will be able to provide additional community support and magnify the impact of these screening and education programs among the medically underserved in Harris County.

We expect to demonstrate the collaboration between See, Test & Treat® Program, Houston Methodist and UT Health and longer term monetary funding will improve utilization by the medically underserved community and increase community support as it becomes an annual event. Professional education and training will assist in the creation of additional events throughout the region and state which will help to increase the number of patients seeking preventive services and improve access to care. We anticipate these interventions will ultimately result in increasing the detection and treatment of early stage or preinvasive cervical and breast disease and improve mortality.

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