Lower Anogenital Tract Disease Management Program

Montefiore Einstein’s Lower Anogenital Tract Disease Management Program is an internationally recognized leader, providing comprehensive, state-of-the art care for those with lower anogenital tract neoplasia or are at risk. Our multidisciplinary team includes world-renowned gynecologic oncologists who collaborate closely with medical and radiation oncologists, infectious disease and human immunodeficiency virus (HIV) specialists, colorectal surgeons and others to deliver seamless, coordinated care and ensure the best possible outcomes for every patient.

Integrating the latest techniques and technologies available, our research-driven, individualized approach  emphasizes HPV and cancer screening, prevention and risk reduction through advanced precancer detection and treatment, lifestyle modification and HPV vaccination when appropriate. We’re ranked in the top 1% of all hospitals in the nation for obstetrics and gynecology and cancer care and are among the highest performing hospitals in the nation for gynecologic cancer surgery, according to U.S. News & World Report. Our Gynecologic Oncology Program is also fully integrated with our National Cancer Institute (NCI)-designated Montefiore Einstein Comprehensive Cancer Center—among the elite 1% of NCI-designated comprehensive cancer centers in the U.S.  

As one of the few programs of its kind in the nation, we serve as an international referral center for the most complex and rare lower anogenital tract cases. Our team provides specialized expertise in advanced screening and diagnostic techniques and offers access to leading-edge HPV testing platforms, including both Food and Drug Administration (FDA)-approved and investigational self-collection-based sampling methods. Our specialists use the most advanced and newly emerging treatments for the full spectrum of anogenital tract diseases—from office-based therapies such as topical agents and precision excisional procedures to advanced radiation and systemic therapies, as well as complex surgical interventions. We prioritize minimally invasive, robot-assisted and fertility-sparing approaches whenever appropriate. Through our clinical trials, patients also have access to innovative diagnostics and novel therapies that may not be available to the general public.

Our Program is centered on long-term wellness and cancer prevention, and emphasizes patient education and shared decision-making—empowering individuals to take an active role in managing their lower anogenital health. Whether you’re undergoing evaluation for abnormal Papanicolaou (Pap) or HPV test results, managing a diagnosis of dysplasia or cancer, recovering from treatment or seeking preventative care, our team is here to provide expert guidance and comprehensive support at every stage of your anogenital health journey.

Our Program provides convenient access to the most advanced screening, diagnostics and treatments for lower anogenital tract diseases, including expert colposcopy and high-resolution anoscopy (HRA). We offer the latest FDA-approved highly sensitive HPV tests that allow for self-collection in a clinical setting as well as investigational at-home self-collected HPV testing through our participation as one of the lead sites in the NCI 'Last Mile' Initiative which supports the Self-collection for HPV testing to Improve Cervical Cancer Prevention (SHIP) Trial Network. We also offer the only FDA-approved p16/Ki-67 dual-stain triage test for HPV-positive cervical cancer screening results as well as extended HPV genotyping to risk stratify and more efficiently triage patients for colposcopy.

We are leading collaborative research and spearheading numerous studies and clinical trials, including several funded by the National Institutes of Health (NIH), translating novel scientific discoveries into new diagnostics and treatments to help improve clinical outcomes. Through our clinical trials, our patients can access emerging technologies and innovative treatments that may otherwise be unavailable to the general public. 

Our researchers actively lead basic, translational and clinical investigations to advance the understanding, diagnosis and treatment of lower anogenital tract diseases. We are leading research focused on human papillomavirus (HPV) and HPV-related cancers—from elucidating how HPV affects cellular function and the molecular mechanisms of viral integration and oncogenesis to developing next-generation diagnostics and treatments. These include novel therapeutic HPV vaccines aimed at preventing and treating cervical, vulvar, vaginal and anal cancers. We are also at the forefront of innovation in screening technologies, driving research on primary HPV testing and other emerging technologies for early cervical cancer detection.

Our researchers are leading studies that address cervical cancer prevention and management in women living with human immunodeficiency virus (HIV) and treatment of anal high-grade squamous intraepithelial lesions (HSIL) to prevent anal cancer. In addition, we’re researching new ways to treat primary and recurrent cervical cancer with proton radiation therapy in collaboration with the New York Proton Center, the only proton facility in New York State. 

Whether you’re undergoing evaluation for abnormal Pap or HPV test results, managing a diagnosis of dysplasia or cancer, recovering from treatment or seeking preventative care, our world-renowned team at the Montefiore Einstein Lower Anogenital Tract Disease Management Program is here to provide you with exceptional support, care and resources tailored to your needs.

Our full-service program offers a comprehensive range of traditional and holistic care at every stage of life from screening, prevention and diagnosis through treatment and recovery. We offer integrated services including social and support programs, genetic counseling and education, care navigation, mental health and wellness support and personalized programs designed to meet each individual’s unique needs.

Our breadth of resources enables us to deliver highly specialized and coordinated care that takes into account the whole person, addressing each individual’s medical needs to optimize outcomes, prevent, eliminate or control cancer, alleviate symptoms, prevent recurrence and promote, preserve and restore the reproductive and sexual health of women across every stage of life. Our team of compassionate and deeply knowledgeable doctors, nurses, specialists and support staff is dedicated to helping you at every step of your anogenital health journey. 

At the Montefiore Einstein Lower Anogenital Tract Disease Management Program, we are committed to preventing cancer and ensuring that everyone has access to the most advanced testing to help detect cancer early and save lives.

Learn about our state-of-the-art, patient-friendly screening methods, designed to reduce your cancer risk and detect cancer at the earliest most treatable stage, even before symptoms appear.

Lower anogenital tract diseases encompass a spectrum of precancerous and cancerous conditions characterized by abnormal cell changes in the tissues of the cervix, vagina, vulva and anus—most often caused by persistent infection by high-risk types of human papillomavirus (HPV). These diseases include dysplasia, or intraepithelial neoplasia, which may progress to invasive cancer without careful monitoring and treatment. Risk factors for developing these diseases include HPV infection (especially high-risk strains), a history of lower anogenital tract dysplasia or cancer, immunosuppression (including HIV infection or prior solid organ transplantation), smoking and a history of lower genital tract precancerous lesions. While early-stage dysplasia is often asymptomatic, progression can lead to abnormal bleeding, pain and visible or palpable lesions. Routine screening is essential for early detection and effective intervention. Advances in HPV testing, cytology, colposcopy, HRA and targeted therapies can allow for earlier detection, minimally invasive treatment and improved outcomes—especially when integrated into comprehensive, individualized care plans.

Our multidisciplinary team of world-renowned gynecologic oncologists, medical and radiation oncologists, colorectal surgeons and HIV and infectious disease specialists collaborates closely across disciplines, developing comprehensive and personalized treatment plans tailored for each patient. Through our multidisciplinary tumor boards, we review each patient’s case, medical history and treatment options in detail before recommending a comprehensive, personalized treatment plan and identifying patients who are candidates for our clinical trials.