Human papillomavirus epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Genital HPV infection is very common, with estimates suggesting that more than 50% of women will become infected with one or more of the sexually transmitted HPV types at some point during adulthood.[1]

Epidemiology

Cutaneous warts

  • Widespread in general population
  • Incidence of common warts is more than plantar or flat warts

Genital warts

  • Anogenital HPV is the most common sexually transmitted infection in the USA [2]
  • In USA, the prevalence of anogenital HPV infection is estimated to be 79 million with incidence of 14 million new cases each year [2]
  • Worldwide, 90% of genital warts is caused by the HPV 6 and 11[3]
  • Prevalence of genital warts is 1% in USA as compared to 10% in Scandinavian countries
  • In USA, the incidence of genital warts has slightly increased in the year 2013
Source: https://www.cdc.gov/

Genital Warts — Initial Visits to Physicians’ Offices, United States, 1966–2013

†Data from CDC

HPV associated cancers

  • In USA, the incidence of HPV associated cancer is 38,793 each year (data 2008-2012)[4]
Cervical cancer
  • Worldwide, the incidence of invasive cervical cancer is 500,000 cases each year.
  • Worlwide, 70% of cervical cancer is caused by the HPV 16 and 18[3]
  • In USA, more than 90% of cervical cancer is caused by HPV.[4]
Oropharyngeal cancer
Anal cancer
  • In USA, the incidence of anal cancer has increased in the last three decades[5][7][8][9]
  • There is increased incidence among HIV positive individuals and incidence has not shown a decline after the advent of antiretroviral therapy.[10]
Recurrent respiratory papillomatosis
  • Rare with rates of about 2 cases per 100,000 children in the United States[11]
  • Common in children born to females having active genital warts at the time of vaginal delivery

Demographics

Following demographic factors may affect the incidence and prevalence of HPV infection:

Age

Cutaneous warts

  • More common in children aged 12-16 yrs of age[12] [13]
  • 10% of children and 3.5% of adults are affected, worldwide

Genital warts

  • Incidence of genital HPV infection increases at the age when individuals begin to engage in sexual activity.[14][15]
  • Highest incidence of genital warts is seen in females aged 20-24 yrs and males aged 25-29 yrs of age[16] (CDC)
  • Prevalence of cervical HPV in females may decline after age 30[17]

HPV associated cancer

  • Incidence is more common in younger age group(sexually active)[18](2196503)[19][20]

Recurrent respiratory papillomatosis

  • Increased incidence is seen in children as compared to adults[21][22]
Source: https://www.cdc.gov/

Human Papillomavirus — Cervicovaginal Prevalence of Types 6, 11, 16 and 18 Among Women Aged 14–59 Years by Age Group and Time Period, National Health and Nutrition Examination Survey, 2003–2006 and 2007–2010

†Data from CDC

Gender

Genital warts

Prevalence per 1000 person-years Among participants in private health plans aged 10–39 years by sex, age group, and year, 2003–2010 is shown in the graph below:

Source: https://www.cdc.gov/

†Data from CDC

HPV associated cancers

  • Out of total 38,793 HPV-associated cancers that occur in the United States each year, 23,000 occur among women, and about 15,793 among men[4]
  • Three fold increased prevalence of HPV associated anal and oropharyngeal cancer in men as compared to women.
  • Increased incidence of oropharngeal and anal cancer among men who have sex with men (MSM)[23][24][25][26][27]
  • Worldwide, the point prevalence of HPV in females is 10%, with highest prevalence among African females[28]

Race

  • There may be increased incidence of high risk HPV infections in African American females as compared to Caucasian[15][29]

References

  1. ↑ Baseman JG, Koutsky LA (2005). "The epidemiology of human papillomavirus infections". J. Clin. Virol. 32 Suppl 1: S16–24. doi:10.1016/j.jcv.2004.12.008. PMID 15753008. *Note: The authors state on page S17 "Overall, these DNA-based studies, combined with measurements of type-specific antibodies against HPV capsid antigens, have shown that most (>50%) sexually active women have been infected by one or more genital HPV types at some point in time."
  2. ↑ 2.0 2.1 http://www.cdc.gov/vaccines/pubs/pinkbook/hpv.html#epi
  3. ↑ 3.0 3.1 http://www.cdc.gov/std/stats14/other.htm#hpv Accessed on October 12, 2016
  4. ↑ 4.0 4.1 4.2 4.3 https://www.cdc.gov/cancer/hpv/statistics/ Accessed on October 12, 2016
  5. ↑ 5.0 5.1 Jemal A, Simard EP, Dorell C, Noone AM, Markowitz LE, Kohler B; et al. (2013). "Annual Report to the Nation on the Status of Cancer, 1975-2009, featuring the burden and trends in human papillomavirus(HPV)-associated cancers and HPV vaccination coverage levels". J Natl Cancer Inst. 105 (3): 175–201. doi:10.1093/jnci/djs491. PMC 3565628. PMID 23297039.
  6. ↑ Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E; et al. (2011). "Human papillomavirus and rising oropharyngeal cancer incidence in the United States". J Clin Oncol. 29 (32): 4294–301. doi:10.1200/JCO.2011.36.4596. PMC 3221528. PMID 21969503.
  7. ↑ Robinson D, Coupland V, Møller H (2009). "An analysis of temporal and generational trends in the incidence of anal and other HPV-related cancers in Southeast England". Br J Cancer. 100 (3): 527–31. doi:10.1038/sj.bjc.6604871. PMC 2658550. PMID 19156144.
  8. ↑ Cook MB, Dawsey SM, Freedman ND, Inskip PD, Wichner SM, Quraishi SM; et al. (2009). "Sex disparities in cancer incidence by period and age". Cancer Epidemiol Biomarkers Prev. 18 (4): 1174–82. doi:10.1158/1055-9965.EPI-08-1118. PMC 2793271. PMID 19293308.
  9. ↑ Shiels MS, Pfeiffer RM, Chaturvedi AK, Kreimer AR, Engels EA (2012). "Impact of the HIV epidemic on the incidence rates of anal cancer in the United States". J Natl Cancer Inst. 104 (20): 1591–8. doi:10.1093/jnci/djs371. PMC 3611819. PMID 23042932.
  10. ↑ Daling JR, Weiss NS, Klopfenstein LL, Cochran LE, Chow WH, Daifuku R (1982). "Correlates of homosexual behavior and the incidence of anal cancer". JAMA. 247 (14): 1988–90. PMID 7062503.
  11. ↑ Sinal SH, Woods CR (2005). "Human papillomavirus infections of the genital and respiratory tracts in young children". Seminars in Pediatric Infectious Diseases. 16 (4): 306–16. doi:10.1053/j.spid.2005.06.010. PMID 16210110. Retrieved 2012-12-10. Unknown parameter |month= ignored (help)
  12. ↑ Allen AL, Siegfried EC (2000). "What's new in human papillomavirus infection". Curr Opin Pediatr. 12 (4): 365–9. PMID 10943818.
  13. ↑ Steele K, Irwin WG, Merrett JD (1989). "Warts in general practice". Ir Med J. 82 (3): 122–4. PMID 2599836.
  14. ↑ Schiffman M, Castle PE (2005). "The promise of global cervical-cancer prevention". N. Engl. J. Med. 353 (20): 2101–4. doi:10.1056/NEJMp058171. PMID 16291978.
  15. ↑ 15.0 15.1 Ho GY, Bierman R, Beardsley L, Chang CJ, Burk RD (1998). "Natural history of cervicovaginal papillomavirus infection in young women". N Engl J Med. 338 (7): 423–8. doi:10.1056/NEJM199802123380703. PMID 9459645.
  16. ↑ Dunne EF, Unger ER, Sternberg M, McQuillan G, Swan DC, Patel SS; et al. (2007). "Prevalence of HPV infection among females in the United States". JAMA. 297 (8): 813–9. doi:10.1001/jama.297.8.813. PMID 17327523.
  17. ↑ Wright TC, Schiffman M (2003). "Adding a test for human papillomavirus DNA to cervical-cancer screening". N Engl J Med. 348 (6): 489–90. doi:10.1056/NEJMp020178. PMID 12571255.
  18. ↑ Gillison ML, D'Souza G, Westra W, Sugar E, Xiao W, Begum S; et al. (2008). "Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers". J Natl Cancer Inst. 100 (6): 407–20. doi:10.1093/jnci/djn025. PMID 18334711.
  19. ↑ Hoevenaars BM, van der Avoort IA, de Wilde PC, Massuger LF, Melchers WJ, de Hullu JA; et al. (2008). "A panel of p16(INK4A), MIB1 and p53 proteins can distinguish between the 2 pathways leading to vulvar squamous cell carcinoma". Int J Cancer. 123 (12): 2767–73. doi:10.1002/ijc.23857. PMID 18798277.
  20. ↑ Chaux A, Cubilla AL (2012). "The role of human papillomavirus infection in the pathogenesis of penile squamous cell carcinomas". Semin Diagn Pathol. 29 (2): 67–71. PMID 22641955.
  21. ↑ Derkay CS, Wiatrak B (2008). "Recurrent respiratory papillomatosis: a review". Laryngoscope. 118 (7): 1236–47. doi:10.1097/MLG.0b013e31816a7135. PMID 18496162.
  22. ↑ Yuan H, Myers S, Wang J, Zhou D, Woo JA, Kallakury B; et al. (2012). "Use of reprogrammed cells to identify therapy for respiratory papillomatosis". N Engl J Med. 367 (13): 1220–7. doi:10.1056/NEJMoa1203055. PMC 4030597. PMID 23013073.
  23. ↑ "STD Facts - HPV and Men". Retrieved 2007-08-17.
  24. ↑ Gillison ML, Broutian T, Pickard RK, Tong ZY, Xiao W, Kahle L; et al. (2012). "Prevalence of oral HPV infection in the United States, 2009-2010". JAMA. 307 (7): 693–703. doi:10.1001/jama.2012.101. PMID 22282321.
  25. ↑ Pickard RK, Xiao W, Broutian TR, He X, Gillison ML (2012). "The prevalence and incidence of oral human papillomavirus infection among young men and women, aged 18-30 years". Sex Transm Dis. 39 (7): 559–66. doi:10.1097/OLQ.0b013e31824f1c65. PMID 22706220.
  26. ↑ Chaturvedi AK, Graubard BI, Pickard RK, Xiao W, Gillison ML (2014). "High-risk oral human papillomavirus load in the US population, National Health and Nutrition Examination Survey 2009-2010". J Infect Dis. 210 (3): 441–7. doi:10.1093/infdis/jiu116. PMC 4110460. PMID 24625808.
  27. ↑ Fakhry C, Gillison ML, D'Souza G (2014). "Tobacco use and oral HPV-16 infection". JAMA. 312 (14): 1465–7. doi:10.1001/jama.2014.13183. PMC 4266546. PMID 25291584.
  28. ↑ de Sanjosé S, Diaz M, Castellsagué X, Clifford G, Bruni L, Muñoz N; et al. (2007). "Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis". Lancet Infect Dis. 7 (7): 453–9. doi:10.1016/S1473-3099(07)70158-5. PMID 17597569.
  29. ↑ Banister CE, Messersmith AR, Cai B, Spiryda LB, Glover SH, Pirisi L; et al. (2015). "Disparity in the persistence of high-risk human papillomavirus genotypes between African American and European American women of college age". J Infect Dis. 211 (1): 100–8. doi:10.1093/infdis/jiu394. PMC 4326315. PMID 25028692.

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