College of American Pathologists
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  Unified HPV terminology—open for comments soon


CAP Today




October 2011
Feature Story

Draft recommendations for a new, unified terminology for HPV-related lesions across all lower anogenital body sites are set to be posted by the end of next month at, and comments will be invited for a limited period.

The CAP and the American Society for Colposcopy and Cervical Pathology joined in late 2010 with the goal of harmonizing terminology across the various lower anogenital body sites with evidence-based knowledge related to the biology of HPV-associated lesions and their clinical management.

Steering Committee chair Teresa Darragh, MD, and Steering Committee members Michael Henry, MD, and Timothy McCalmont, MD, presented the objectives and preliminary draft recommendations in a session at the CAP ’11 annual meeting last month. More than 75 percent of the attendees indicated they have experienced difficulty in understanding a pathology report from another institution or in communicating with clinicians about HPV-related precancerous lesions.

Through a systematic process, five working groups of more than 50 pathologists, dermatopathologists, clinicians, and surgeons have been reviewing the literature. Working groups have evaluated the various terminologies used for precancerous and early invasive stages of the lower anogenital tract across both genders (cervix, vagina, vulva, penis, scrotum, anus, and perianus) to first determine if they could be harmonized. Another work group has focused on the use of molecular markers to determine what biomarkers, if any, could be used to reduce interobserver variability in histopathology and offer predictive information. Yet another work group is focusing now on the clinical impact and implementation issues likely to come from recommended terminology changes.

The draft recommendations will propose that terminology reflect biology, assess risk, and guide management, and that terminology be unified across all body sites. To review the details and post your comments, visit next month.

More than 40 participating organizations will vote on the final recommendations March 13–14, 2012 in San Francisco. Observers are welcome to attend.