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IU specialist joins U.S. team to read Pap tests in Botswana campaign against cervical cancer

May 22, 2014

Normally when Barbara McGahey Frain of the IU School of Medicine goes to evaluate a pathology sample, she needs only to walk down the hall.

Barbara McGahey Frain

Barbara McGahey Frain

But recently she and 10 colleagues from around U.S. recently traveled more than 8,000 miles to examine the small sample slides in a volunteer medical outreach venture organized by the American Society for Clinical Pathology. The group helping medical officials in Botswana work through a backlog of Pap smears from May 17 until June 2.

The trip is a first-time opportunity for Frain, a clinical assistant professor who teaches cytotechnology -- the science of examining cells under the microscope to detect cancer and other problems -- at the School of Medicine's Health Professions Programs.

"I'm interested in seeing how they do this in another part of the world, and I hope my skills can help someone out," she said of the trip to Gaborone, the capital of Botswana, a nation of about 2 million people in southern Africa.

The Pap smear is a screening test for cervical cancer in which cells from the cervix are placed on a glass slide and then examined under a microscope. Cytotechnologists look for abnormally shaped cells with larger-than-normal nuclei. If such cells are detected, patients are called back for a biopsy and, if necessary, treatment.

The availability of the test has dramatically reduced the incidence of cervical cancer in the United States and other developed countries. But the incidence is much higher elsewhere, including Botswana, where it is the leading cause of cancer deaths in women.

In response, the Botswana government has initiated a national cervical cancer prevention program, which resulted in a large number of Pap exams but led to a shortage of professionals to read the slides, said Shannon Castle, director of the Center for Global Health at the American Society for Clinical Pathology.

The society previously sent teams to Botswana to work on a backlog of more than 2,000 histology specimens, resulting in the invitation to reduce the Pap test backlog.

"There are seven cytotechnologists in all of Botswana," Castle said. "To add 10 more cytotechnologists can really have an impact in improving the delivery of care."

Frain put her name in for the project in response to the society's call for volunteers in April. Although she has not participated in a foreign outreach project before, she did help IU School of Medicine investigator Darren Brown, M.D., professor of medicine, read 300 Pap smears collected in Ecuador for research on cervical cancer and the human papillomavirus, which is responsible for many such cancers.

Other than a family trip to England and a professional meeting in Toronto, "My passport has not been used extensively," Frain said.

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