College of American Pathologists
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  Volunteers needed in Guyana


cap today



June 2006

The Remote Area Medical Cervical Cancer and Women’s Health Team needs volunteer pathologists and cytologists to interpret Pap specimens and tissue biopsies from colposcopic exams, LEEPs, and hysterectomies for women in remote regions of Guyana.

The team, known as RAM, began its cervical cancer screening in Guyana in November 2003, and in semiannual expeditions since then has screened 944 patients and performed colposcopies, LEEPs, and hysterectomies, mostly in Guyana’s villages. All pathologic studies have been done at the University of Virgina, Charlottesville, says Rebecca Kightlinger, DO, assistant professor of obstetrics and gynecology at the University of Virginia and a RAM team member. Now the group is heading into the mountains and jungles on foot and by ATV and canoe.

“Because of the difficulty accessing the mountainous regions of the rain forest,” Dr. Kightlinger says, “we would like to get the pathology results as soon as possible and treat these patients in one visit. To do this, we would have to have our biopsies read in Guyana.”

Some of Guyana’s remote sites require the RAM teams to parachute in. “So we’d like to keep them there, airlift the specimens out, and send them to Georgetown Public Hospital where an American pathologist would read them,” she says. The pathologist would radio the results to the physician on site. Patients with cancer or CIN 3 with positive margins will be transported to Georgetown where a gynecologic oncology team will treat them. “It’s the best way we can see to deliver good care and reduce the possibility of loss to followup,” she says.

Guyana’s Ministry of Health has entrusted gynecologic care among the indigenous AmerIndian tribes in the remote interior of the country to RAM. Since 2003 the team has seen a 6.6 percent incidence of CIN 3 and diagnosed four cases of invasive squamous cell carcinoma.

RAM is also setting up an OB/GYN residency in Georgetown and will need pathologists who can lecture on gynecologic pathology.

If interested, contact Dr. Kightlinger at For more about RAM, visit


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