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

Background

The 2012 guidelines, "LAST Project for HPV-associated Lesions: Background and 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.

This guideline update will reaffirm the use of a unified nomenclature for HPV-associated preinvasive squamous lesions of the lower anogenital tract and to refresh guidance on biomarker use and to better assist efforts for standardization.

All stakeholders—including pathologists, oncologists, histotechnologists, hospital or laboratory managers, and patient advocacy group representatives—are encouraged to read and comment on the draft recommendations until September 3, 2025. 

Open Comment Period Information 

Review the following resources to provide your feedback:

• Data extraction references (PDF)
• Draft recommendations and GRADE glossary (PDF)
• Expert panel disclosures of interest report (PDF) 

Disclaimer

The information, data, and draft recommendations provided by the College of American Pathologists are presented for informational and public feedback purposes only. The draft recommendations and supporting documents will be removed on September 10, 2025. The draft recommendations along with the public comments received and completed evidence review will be reassessed by the expert panel in order to formulate the final recommendations. These draft materials should not be stored, adapted, or redistributed in any manner.

Please note: comments are not posted automatically. All comments will be posted on a weekly basis beginning August 20, 2025.