Dr. Erica Montes

-What is the Pap test for?

The Pap is used to screen for cervical cancer by detecting any cervical cell abnormalities that are usually caused by an HPV infection.

-What should someone know before getting a Pap test for the first time?

It is recommended to get your first Pap test at age 21, regardless of sexual activity or not. When you are under 30, we only screen for cervical cell abnormalities, and after 30, we do co-testing, which is screening for cell abnormalities and high-risk HPV infection.

What causes cervical cancer? And how common is it? 

In almost all cases, cervical cancer is due to human Papillomavirus (HPV) infection. It is the fifteen most common cancer in Americans with cervixes.

-Can a general practitioner do a Pap test or does a speciality doctor have to do it? The actual process of collecting cervical cells for a Pap is fairly simple. Most healthcare providers  can perform one. But, if your Pap or HPV result is abnormal, you likely will be sent to an OB/GYN for further evaluation and testing through a procedure called colposcopy.

-How long does the Pap test take to complete? 

The collection of cells takes seconds. Overall, from the start of the exam to the end, it’s just a few minutes or less.

-I am afraid of the speculum. What should I do? Why is it so big? 

Ask your physician or healthcare provider to use a smaller speculum for your comfort. Also having it warmed up helps with discomfort. Finally, if you have had a trauma in your past that makes these types of exams difficult, please speak up. At times, we can collect cells without a speculum.

What should I know about an abnormal test? 

An abnormal test can include abnormal cervical cells or testing positive for high risk HPV. The next step and follow up will be determined depending on the grade of abnormality, if the HPV test is positive or not, your age and your Pap history.

-I’m concerned about costs. What resources are available to me? 

Community clinics provide resources for those looking for affordable care and you can often pay based on income. There is also the The National Breast and Cervical Cancer Early Detection Program is a federally funded program that helps uninsured and underinsured women get regular Paps.

-What is co-testing and should I do it? 

Co-testing is when a Pap and HPV test are done together. This is all done in the same collection and is the recommended screening for women ages 30-65.

-I am a trans man. What is my risk level of cervical cancer? Is my risk level higher? AND I am a transwoman and had a vaginoplasty. Do I need a Pap test?

If you are a trans-man and still have your uterus and cervix, you definitely need a Pap based on routine screening. If you had a hysterectomy that removed your cervix and didn’t have a history of high-grade dysplasia, then you don’t need to be screened.

For a trans-woman, cervical cancer screening is not necessary with a neovagina since it is typically lined with penile skin. There is only one published case report of vaginal dysplasia in this population, and evidence suggests that the risk of neoplasia is extremely small.

-Is it safe to get the Pap test during the COVID-19 pandemic? 

Yes, absolutely. Remember that routine screening for cervical cancer with Pap tests for women under the age of 30 is still every three years, and co-testing is recommended every five years for women ages 30-65 . However, it is still extremely important to schedule your annual well-woman exam, which will include a pelvic exam, breast exam and cervical cancer screening if needed.

-I missed my Pap test during the lockdown. What should I do? 

Make your appointment for when you’re next available. We are happy to see you anytime!

-Do we have to remove the cervix during a hysterectomy? 

The cervix doesn’t necessarily need to be removed, and that procedure would be called a supracervical hysterectomy. Still, if you have a history of abnormal Paps and are going to get a hysterectomy, I would recommend removing the cervix as well. Most physicians routinely remove it at time of hysterectomy. 

-At what age can people with a cervix get their first Pap test? 

21 is the recommended age regardless of sexual activity.