Kristin Mitchener

Some may call it curiosity. Some may call it keeping the oath of a physician. Others may say it was fate that led late pathologist Dr. Gene Herbek to the indigenous women of Standing Rock Indian Reservation. Circa late 1990’s, Dr. Herbek lived and worked near Standing Rock. He recognized the women of Standing Rock had the highest rate of cervical cancer in the US and one of the lowest survival rates. “Why is that?” he asked. He took another step. “What can we do about it?” It was his next step that would change the face of medicine for so many underserved women. In 2001, he created See, Test & Treat® (STT), a program that offers free Pap smears for cervical cancer and breast cancer screening with same-day results to women in low-resource communities. A key component that he knew must be part of the program: compassionate, culturally, and linguistically appropriate care. From Standing Rock arose a small group of brave women who were his first patients in the inaugural program.

What started with one pathologist and one patient population in 2001 is blossoming to this day. In 2011, Dr. Herbek joined forces with the College of American Pathologists (CAP) Foundation. “When CAP Foundation first took over, there were two events a year. Since 2011, over 100 STT events led by pathologists have served over 6500 women and we are now up to 13 events a year,” CAP Foundation President Carey Z. August, MD, FCAP tells us. “We have expanded Dr. Herbek’s vision of how to deliver this level of care to people who aren’t getting it and doing it in a compassionate, sensitive way that helps patients understand the need for taking care of themselves and addresses all aspects of their healthcare and their family’s healthcare. We’re proud to have taken the ball and run with it.”

We have expanded Dr. Herbek’s vision of how to deliver this level of care to people who aren’t getting it and doing it in a compassionate, sensitive way that helps patients understand the need for taking care of themselves and addresses all aspects of their healthcare and their family’s healthcare.

“The women who come to us are under-resourced, uninsured or underinsured. We want people who don’t have insurance, who don’t have the ability to come otherwise. We conduct follow-ups to see how many abnormal cases we pick up at STT events. We found that 18% of breast cancer screening results and 8% of cervical cancer screening results required additional work up and follow up; this is higher than the national average. This only reinforces why it’s so important we target these underserved populations, populations of women who are not comfortable entering the medical system, patients who don’t have resources, time, childcare, etc. Pathologists have reached out to women’s homeless shelters so the population at shelters can keep getting their screenings and treatments. We do everything we can to remove barriers so that these women learn that you can go get your screenings and get your care and be comfortable,” says Dr. August.

While the women are the stars, the pathologists are the masters of ceremonies. Pathologists work in unison with other healthcare professionals to meet the needs of the community. Dr. August explains, “Some STT events have included blood pressure screenings, information about exercise, a healthy diet and cooking, and knowledge about genetic aspects of cancer. Patients get to sit with a pathologist or pathology resident and look at their own cells under the microscope. The pathologists explain the findings of normal and abnormal on the Pap screenings and discuss what the patient should do next and then direct them to accessing care.”

Pathologists are even inspiring the women they serve at STT events to become advocates for the program. Dr. August tells us, “A woman in Mississippi heard about STT through her church. She came to the event on a Saturday and was found to have advanced cervical cancer. By Wednesday she had her biopsy and initial workup complete and was already seeing a radiation oncologist. We literally saved her life. She became a huge advocate and now drives other women from her community to help get them to STT events. We are always shocked at the impact these events have.”

We are helping women understand they can go to the doctor, they can bring their family to the doctor. They go back to their communities and tell them ‘we can do this.’

From Standing Rock over twenty years ago to communities around the country today, STT has the power to change, and save, lives. Dr. August says, “For a woman in an at-risk population to come to STT, have her Pap smear and breast cancer screening by someone who speaks her language, have her results given to her and discussed by someone who speaks her language and understands her culture -- it knocks down so many barriers. And not only for that one woman and that one day. We are helping women understand they can go to the doctor, they can bring their family to the doctor. They go back to their communities and tell them ‘we can do this.’ It starts with one patient, one set of tests and it balloons from there.”

To learn more about See, Test & Treat, visit the CAP Foundation website at https://foundation.cap.org/what-we-fund/see-test-treat/.