The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology
Authors: Darragh Teresa M. , Colgan Terence J. , Cox J. Thomas , Heller Debra S. , Henry Michael R. , Luff Ronald D. , McCalmont Timothy , Nayar Ritu , Palefsky Joel M. , Stoler Mark H. , Wilkinson Edward J. , Zaino Richard J. , Wilbur David C. , Wilbur David C. , Darragh Teresa M. , Henry Michael R. , McCalmont Timothy , Luff Ronald D. , Wilkinson Edward J. , Cox J. Thomas , Wilkinson Edward J. , O'Connor Dennis M. , Reynolds R. Kevin , Selim M. Angelica , Scurry James , Henry Michael R. , Chelmow David , Howell Lydia P. , Ronnett Brigitte , Waxman Alan G. , McCalmont Timothy , Haefner Hope K. , Leslie Kieron S. , Shea Christopher , Staats Paul N. , Palefsky Joel M. , Council Leona , Lytwyn Alice , Winkler Barbara , Roberts Jennifer , Colgan Terence J. , Downs Levi , Laucirica Rodolfo , Zaino Richard J. , Heller Debra S. , Allbritton Jill , Ioffe Olga , Joste Nancy , Darragh Teresa M. , Berry J. Michael , Lin Oscar , Welton Mark , Otis Christopher N. , Wilbur David C. , Stoler Mark H. , Bentz Joel S. , Kong Christina S. , Quade Bradley , Schwartz Mary R. , Luff Ronald D. , Nayar Ritu , Castle Philip E. , Duggan Maire , Garcia Francisco A. R. , Moriarty Ann T. , Niedt G. Chip , Carter Alicia , Goodman Marc , Neal Margaret , Reddy Vijaya , Robboy Stanley , Saraiya Mona , Silverberg Steven , Spires Susan 
Published: June 2012

The terminology for human papillomavirus (HPV)–associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lower anogenital sites. The goal was to create a histopathologic nomenclature system that reflects current knowledge of HPV biology, optimally uses available biomarkers, and facilitates clear communication across different medical specialties. The Lower Anogenital Squamous Terminology (LAST) Project was cosponsored by the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology and included 5 working groups; 3 work groups performed comprehensive literature reviews and developed draft recommendations. Another work group provided the historical background and the fifth will continue to foster implementation of the LAST recommendations. After an open comment period, the draft recommendations were presented at a consensus conference attended by LAST work group members, advisors, and representatives from 35 stakeholder organizations including professional societies and government agencies. Recommendations were finalized and voted on at the consensus meeting. The final, approved recommendations standardize biologically relevant histopathologic terminology for HPV-associated squamous intraepithelial lesions and superficially invasive squamous carcinomas across all lower anogenital tract sites and detail the appropriate use of specific biomarkers to clarify histologic interpretations and enhance diagnostic accuracy. A plan for disseminating and monitoring recommendation implementation in the practicing community was also developed. The implemented recommendations will facilitate communication between pathologists and their clinical colleagues and improve accuracy of histologic diagnosis with the ultimate goal of providing optimal patient care.