D'Nyce Williams, MD, MPH, MPA


Associate Professor of Clinical OB/GYN and Project Manager, Contraceptive Research and Development Program/Centers for Disease Control and Prevention/Morehouse School of Medicine, Atlanta, GA

Dr. Williams’ current interests and activities involve improving access and utilization of preventive health services, such as contraception, preconception and obstetrical care, and STI/HIV prevention strategies among reproductive-aged women. In her role as a CONRAD Medical Officer, she serves as a clinical consultant and develops policies and procedures for domestic and international clinical trials involving prevention of sexually transmitted infections among high-risk women in low-resource areas. She serves as Obstetrics Chief and provides clinical services to women in the International Medical Center at Grady Memorial Hospital, a model program where bilingual staff and clinicians provide comprehensive, culturally-sensitive health services to patients with limited English proficiency. She also participates in the education and training of residents and medical students. Dr. Williams serves on local, state and national committees evaluating quality improvement, birth outcomes, and community-based research projects aimed at health improvement and disparity reduction in underserved populations and she serves as a member of the board of directors of a community health center.

Dr. Williams, a native of California, received a master of public health from the University of California, Berkeley and a medical degree at the University of California, Davis. She completed residency training in Obstetrics and Gynecology at the University of California, San-Francisco-Fresno, and received a Master in Public Administration from the Kennedy School of Government at Harvard University.







Assessing Follow-up among Black and Hispanic Women in the Breast and Cervical Cancer Early Detection Program in Massachusetts


Breast cancer is the second leading cause of all deaths and cancer deaths among US women. Cervical cancer, although largely preventable, is a cause of excess mortality. Low-income and minority women have a higher mortality from breast and cervical cancer than higher income and/or Non-Hispanic White women. Black women have the highest mortality from both. Hispanic women are at great risk because they are disproportionately uninsured. The purpose of this project was to determine whether racial/ethnic variation in follow-up related to screening, diagnosis and treatment, among the Women’s Health Network (WHN) population.

National Breast and Cervical Cancer Early Detection Program (NBCCEDP) was authorized by Congress via the Breast and Cervical Cancer Mortality Prevention Act of 1990. Congress currently appropriates $160 million to provide breast and cervical cancer screening, diagnostic services, public awareness and education for low-income women. Treatment is not covered. The Breast and Cervical Cancer Prevention and Treatment Act of 2000 was enacted to provide states with funds for medical treatment for the NBCCEDP population. The Act has been implemented in many states, but not in Massachusetts. WHN is the NBCCEDP in Massachusetts.


A literature review of follow-up care in cancer screening programs was completed. The WHN database from 1992-2002 was analyzed. Complete and incomplete evaluations, follow-up, and stage at diagnosis were obtained. Race/ethnicity categories included: Non-Hispanic White, Black, and Hispanic. All state NBCCEDP programs were surveyed to ascertain the status of the Treatment Act in their states. Eighty percent responded. Interviews were conducted with WHN administrative staff and selected program site coordinators.


Breast and cervical cancer diagnostic evaluation completion in the WHN population exceeded 90%. However, Black and Hispanic women had lower percentages than Non-Hispanic White women. Among the women with incomplete evaluations, Black and Hispanic women were more likely to have pending evaluations or be lost to follow-up.
By July 1, 2002, 36 of the 40 states will have implemented the Treatment Act.


  •     Public awareness and recruitment efforts should be targeted toward Black and Hispanic women.
  •     Implement a monitoring system to accurately determine and track the length of time to diagnosis.
  •     Identify and contract with a preferred group of health providers and facilities to provide effective and appropriate treatment to WHN patients.
  •     Identify and implement a system that ensures equal access to all available treatment options and includes adequate long-term follow-up.
  •     Require the development and implementation of a uniform tracking/follow-up system for WHN patients to eliminate racial/ethnic differences in follow-up.

Faculty Preceptors:

John McDonough, Dr.P.H., Schneider Institute for Health Policy, Brandeis University
Brian Gibbs, PhD, Division of Public Health Practice, Harvard School of Public Health