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CAP-ASCCP Lower Anogenital Squamous Terminology (LAST) for HPV-Associated Lesions

LAST Project Consensus Recommendations and Resources

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Updated November 19, 2013

Consensus Recommendations

The CAP Center and the ASCCP have released a joint guideline – The Lower Anogenital Squamous Terminology Standardization Project for HPV-associated Lesions: Background and Consensus Recommendations.

The LAST Project’s consensus recommendations provide a standardized diagnostic histopathologic terminology for squamous lesions associated with human papillomavirus (HPV) across lower anogenital tract body sites, including recommendations for the appropriate use of biomarkers  to identify and distinguish these lesions.

Implementation of the new consensus recommendations will result in more reliable and reproducible diagnoses based on our current knowledge of the biology of HPV—ultimately leading to more effective patient management and improved patient outcomes. Physicians will receive more consistent biopsy diagnoses to help assess management options, including conservative follow-up or treatment, and more accurately evaluate a patient’s risk of having precancer.

The LAST consensus recommendations are based on an extensive literature review of terminology used historically, how terminology influences management of HPV-associated lesions by body sites, and the role of biomarkers in diagnosis. Thirty-five professional organizations participated in the deliberations, revisions, and final approval of the LAST consensus recommendations.

On June 28, 2012, the final approved recommendations were released online by joint publication in the Archives of Pathology & Laboratory Medicine and the Journal of Lower Genital Tract Disease.

LAST Consensus Recommendations and Methodology Supplement LAST Consensus Recommendations and Methodology Supplement

The Lower Anogenital Squamous Terminology Standardization Project for HPV-associated Lesions: Background and Consensus Recommendations

Detailed information regarding the LAST Project’s 2011-12 comprehensive literature process, evidence grading for biomarkers, the COI policy and a list of the participating organizations, etc., may be accessed in the LAST Supplemental Digital Content available online within the manuscript.

LAST Consensus Recommendations Resources LAST Consensus Recommendations Resources

LAST CAP TODAY Articles
The President’s Column and a Special Article in July’s CAP TODAY about the CAP-ASCCP LAST Project providing insight on the impact of the LAST Recommendations for biomarkers and other key outcomes.

Archived PHC Webinar: Biomarkers in HPV-associated Lower Anogenital Squamous Lesions from the CAP-ASCCP Lower Anogenital Squamous Terminology Project

Archived PHC Webinar #2: Applying the CAP-ASCCP LAST Project Principles in Clinical Practice: Case Examples Illustrating Biomarker Usage

Summary of The LAST Project Consensus Recommendations

LAST Biomarkers for HPV-Associated Lesions Algorithm Chart (PDF, 502 KB)
A fast in-hand reference tool for the recommended use of biomarkers.

LAST PowerPoint Presentation
(PDF, 43 MB)
A presentation to share recommendations for terminology and the use of biomarkers with colleagues, grand round presentations, and other educational offerings.

ASCCP Educate the Educators’ Newsletter (Special LAST Issue)
(PDF, 269 KB)
In-depth discussions on the key LAST Work Group topics.

COMING SOON!

LAST Online Image Atlas
A free online atlas to review cases inclusive of clinical correlation, biomarkers, and reporting parameters.

LAST Consensus Recommendations - FAQs LAST Consensus Recommendations – FAQs

See Frequently Asked Questions (PDF, 126 KB) for further information.

Q & A on Case Examples Illustrating Biomarker Usage
(PDF, 41 KB)

LAST Consensus Recommendations Feedback LAST Consensus Recommendations Feedback

Comment on the Consensus Recommendations

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