The LAST guidelines in clinical practice: implementing recommendations for p16 use.


Journal Article

OBJECTIVES: To determine the impact of implementing p16 Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions (LAST) guidelines, we compared p16 use and follow-up data before and after implementation of the guidelines. METHODS: We reviewed all cervical biopsy specimens diagnosed by two pathologists before and after implementation of the LAST guidelines and calculated the rate of and reason for p16 use across all biopsy specimens, high-grade squamous intraepithelial lesion (HSIL) detection, and follow-up. RESULTS: In total, 1,829 and 1,623 cervical biopsy specimens were reviewed in periods A and B, respectively. Overall p16 use increased from 2.8% to 6.2% (P < .001). Recommendations 2 and 4 increased from 0.16% and 0% of all cervical biopsy specimens in period A to 1.4% and 1.9% in period B, respectively (P < .0001). p16+ HSIL increased from 1.4% to 2.3% (P < .05). The positive predictive value of p16+ HSIL increased from 48% to 76% (P < .05). CONCLUSIONS: Implementation of the p16 LAST guidelines resulted in a significant increase in p16 use and a significant increase in the positive predictive value of p16+ HSIL.

Full Text

Duke Authors

Cited Authors

  • Clinton, LK; Miyazaki, K; Ayabe, A; Davis, J; Tauchi-Nishi, P; Shimizu, D

Published Date

  • December 2015

Published In

Volume / Issue

  • 144 / 6

Start / End Page

  • 844 - 849

PubMed ID

  • 26572990

Pubmed Central ID

  • 26572990

Electronic International Standard Serial Number (EISSN)

  • 1943-7722

Digital Object Identifier (DOI)

  • 10.1309/AJCPUXLP7XD8OQYY


  • eng

Conference Location

  • England