LAST Frequently Asked Questions (FAQs)

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LAST Project Consensus Recommendations FAQs (Click Question for Answer)

Q1. What resources are available for learning this new terminology and improving interpretations of p16 staining in LAT lesions?

Q2. What are the benefits to changing terminology?

Q3. Why now? Our laboratory and clinicians are working fine with what we have in place currently.

Q4. How do pathologists communicate the new terms to their clinical colleagues?

Q5. How do we distinguish between cytologic High-Grade Squamous Intraepithelial Lesion (HSIL) and a biopsy with HSIL?

Q6. How will clinicians manage their younger patients with CIN 2 if this is not specifically designated?

Q7. How will we know if patients are being treated more appropriately and not over-treated since we are now placing CIN 2 with CIN 3?

Q8. Why isn’t there a category of “Uncertain or -IN-Indeterminate”?

Q9. The new terminology requires a change in our LIS system and we are unable to complete until next year. Will we be penalized?

Q10. Is the terminology applicable to HPV-associated lesions of the oropharynx?

Q11. Does the terminology apply to cervical glandular lesions?

Q12. Will cancer registries collect data on HSIL in the same manner they’ve collected CIN 3 and will it impact current and future epidemiologic trends?

Q13. Why “superficially invasive” and not “microinvasive”?

Q14. How can the criteria for “superficially invasive” be different for each body site?

Q15. How will this new terminology affect training for residents, fellows and their program directors?

Q16. How will the new terminology be asked on the boards?

Q17. Where in the report should lymph-vascular invasion (LVI) be stated?

Q18. What is the definition of the perianus since clinicians from multiple specialties may be using different treatment protocols?

Q19. Why do the recommendations specifically suggest the use of p16 as an ancillary test?

Q20. Is p16 the only recommended method of confirming HPV in tissue? Can I use another marker in conjunction with p16?

Q21. How will p16 use be monitored?

Q22. How will CIN 2 p16-positive and CIN 2 p16-negative patients be monitored in routine settings to determine if the division is clinically relevant?

Q23. How will I know if a morphologically indeterminate lesion between LSIL and HSIL is a true HSIL when a large number of LSILs are p16-positive?

Q24. What about the use of genotyping to aid in diagnosis of HPV-associated lesions?

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