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

Teresa M. Darragh(University of California, San Francisco), Terence J. Colgan(Mount Sinai Hospital), J. Thomas Cox(Rutgers, The State University of New Jersey), Debra S. Heller(Rutgers, The State University of New Jersey), Michael Henry(Mayo Clinic in Arizona), Ronald D. Luff(Thomas Jefferson University), Timothy H. McCalmont(University of California, San Francisco), Ritu Nayar(Northwestern University), Joel M. Palefsky(University of California, San Francisco), Mark H. Stoler(University of Virginia Health System), Edward J. Wilkinson(University of Florida), Richard J. Zaino(Penn State Milton S. Hershey Medical Center), David C. Wilbur(Harvard University), David C. Wilbur(Harvard University), Teresa M. Darragh(University of California, San Francisco), Michael Henry(Mayo Clinic), Timothy H. McCalmont(University of California, San Francisco), Ronald D. Luff(Thomas Jefferson University), Edward J. Wilkinson(University of Florida), J. Thomas Cox(Rutgers, The State University of New Jersey), Edward J. Wilkinson(University of Florida), Dennis M. O’Connor, R. Kevin Reynolds, M. Angélica Selim, James Scurry, Michael Henry(Mayo Clinic), David Chelmow(Harvard University Press), Lydia Howell, Brigitte M. Ronnett, Alan G. Waxman, Timothy H. McCalmont(University of California, San Francisco), Hope K. Haefner, Kieron Leslie, Christopher M. Shea, Paul N. Staats, Joel M. Palefsky(University of California, San Francisco), Alice Lytwyn, Barbara Winkler, Jennifer M. Roberts, Terence J. Colgan(Mount Sinai Hospital), Levi S. Downs(University of Toronto), Rodolfo Laucirica, Richard J. Zaino(Penn State Milton S. Hershey Medical Center), Debra S. Heller(Rutgers, The State University of New Jersey), Jill Allbritton(Rutgers, The State University of New Jersey), Olga B. Ioffe, Nancy E. Joste(University of Toronto), Teresa M. Darragh(University of California, San Francisco), J. Michael Berry(University of California, San Francisco), Oscar Lin, Mark L. Welton, Christopher N. Otis(University of Virginia), David C. Wilbur(Harvard University), Mark H. Stoler(University of Virginia Health System), Joel S. Bentz(University of Virginia), Christina S. Kong, Bradley J. Quade, Mary R. Schwartz, Ronald D. Luff(Thomas Jefferson University), Ritu Nayar(Northwestern University), Philip E. Castle(Northwestern University), Máire A. Duggan, Francisco García, Ann Moriarty, Greg Niedt, Alicia Carter, Marc T. Goodman, Margaret B. Neal, Vijaya Reddy, Stanley J. Robboy, Mona Saraiya, Steven M. Silverberg, Susan E. Spires
Archives of Pathology & Laboratory Medicine
June 28, 2012
10.5858/arpa.lgt200570
Cited by 996Open Access
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Abstract

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 co-sponsored 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.

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