ABSTRACT: Knowledge of the natural history, epidemiology, and basic science of human papillomavirus (HPV) and precancerous lesions of the cervix is rapidly evolving. Guidelines have been revised several times over the past decade to incorporate new evidence and technologies 1 2. The American Society for Colposcopy and Cervical Pathology (ASCCP) clinical management guidelines were revised again in 2012 3, and this Practice Bulletin is adapted with permission from the ASCCP publication 2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests and Cancer Precursors. Important changes to these guidelines include the following:
Defining when to return to routine screening after treatment or resolution of abnormalities given the longer screening intervals recommended by the updated American Cancer Society screening guidelines 4
Improving incorporation of HPV testing
Applying guidelines previously developed for adolescents to individuals aged 21–24 years
Integrating new data on risk of high-grade precursor lesions and cancer
The ASCCP–College of American Pathologists Lower Anogenital Squamous Terminology Standardization (LAST) Project recommended standardizing histopathologic terminology for HPV-associated squamous intraepithelial lesions and superficially invasive squamous carcinoma across all lower anogenital tract sites 5. The purpose of this document is to present the most recent revisions to guidelines for managing abnormal cervical cancer screening test results and cervical cancer precursors, describe the LAST Project terminology, and provide guidance on applying the new management guidelines with this terminology.