CAP/ASCCP LAST Project recommendations for better diagnosis of HPV-associated lesions

College of American PathologistsJul 4 2012

The College of American Pathologists (CAP) and the American Society for Colposcopy and Cervical Pathology (ASCCP) jointly issued The Lower Anogenital Squamous Terminology (LAST) Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations.

The CAP/ASCCP LAST Project consensus recommendations were released on June 28, 2012, in the online editions of Archives of Pathology & Laboratory Medicine (Archives) and in the Journal of Lower Genital Tract Disease (JLGTD), the official journals of the CAP and the ASCCP, respectively.

The new recommendations provide standardization of diagnostic terminology of lesions associated with the human papillomavirus (HPV) across lower anogenital tract body sites, including the appropriate use of biomarkers to distinguish these lesions. Through implementation of the recommendations, the two organizations aim to enhance communication between pathologists and clinicians leading to more effective patient management of HPV-associated disease and, ultimately, improved patient outcomes.

"The CAP/ASCCP LAST Project consensus recommendations were developed based on the availability of new science, allowing pathologists to better classify HPV-associated lesions," said Teresa M. Darragh, MD, FCAP, the lead author of and steering committee co-chair for the LAST Project consensus recommendations and a professor of clinical pathology and obstetrics, gynecology & reproductive sciences at the University of California San Francisco (UCSF) and an attending physician in the UCSF/Mt. Zion Dysplasia Clinic in San Francisco, Calif. "With this information, patients along with their physicians will be able to better weigh the benefits and risks of management options associated with HPV infections, allowing them to make more informed decisions about their health."

The recommendations were developed based on an extensive literature review of the terminology used historically, how terminology influences management of HPV-associated lesions by body sites, and the role of biomarkers in their diagnosis.

The CAP Pathology & Laboratory Quality Center, "the Center," a forum for developing evidence-based guidelines and consensus recommendations, led the joint development of the LAST Project's consensus recommendations. Thirty-five professional organizations collaborated and participated in the review and final approval of the recommendations, which will be published in the July issue of JLGTD and in the October issue of Archives.