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.

Implementation of the 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.

The final approved recommendations are available in the Archives of Pathology & Laboratory Medicine.

Guideline Information

• Guideline status: Research and Review
• Published online ahead of print: June 28, 2012
• Originally published: October 2012
• Joint Partner: American Society for Colposcopy and Cervical Pathology
• Update Open Comment Period: August 13-September 3, 2025  

Guideline Tools & Resources

The following tools and resources are available to help implement the guideline: 

• Summary of Recommendations
• Algorithm Chart
• Teaching Presentation
• ASCCP Educate the Educators Newsletter
• Case Examples Illustrating Biomarker Usage Webinar and Q & A
• Methodology Supplement (Supplemental Digital Content)