Abstract
BackgroundMost individuals are infected with human papillomavirus (HPV) at least once in their lifetime. Infections with low-risk types can cause genital warts, whereas high-risk types can cause malignant tumors. The aim of this study was to determine the burden of anogenital diseases potentially related to HPV in young women based on German statutory health insurance claims data.MethodsWe conducted a retrospective claims data analysis using the “Institute for Applied Health Research Berlin” (InGef) Research Database, containing claims data from approximately 4 million individuals. In the period from 2012 to 2017 all women born in1989–1992, who were continuously insured between the age of 23–25 years were identified. Using ICD-10-GM codes (verified diagnosis in the outpatient sector or primary or secondary diagnosis in the inpatient sector) the administrative prevalence (95% confidence interval) of genital warts (A63.0), anogenital diseases grade I (K62.8, N87.0, N89.0, N90.0), grade II (N87.1, N89.1, N90.1) and grade III (D01.3, D06.-, D06.0, D07.1, D07.2, N87.2, N89.2, N90.2) was calculated (women with diagnosis divided by all women).ResultsFrom 2012 to 2017, a total of 15,358 (birth cohort 1989), 16,027 (birth cohort 1990), 14,748 (birth cohort 1991) and 14,862 (birth cohort 1992) women at the age of 23–25 were identified. A decrease of the administrative prevalence was observed in genital warts (1.30% (1.12–1.49) birth cohort 1989 vs. 0.94% (0.79–1.10) birth cohort 1992) and anogenital diseases grade III (1.09% (0.93–1.26) birth cohort 1989 vs. 0.71% (0.58–0.86) birth cohort 1992). In anogenital diseases grade III, this trend was especially observed for severe cervical dysplasia (N87.2) (0.91% (0.76–1.07) birth cohort 1989 vs. 0.60% (0.48–0.74) birth cohort 1992). In contrast, anogenital diseases grade I (1.41% (1.23–1.61) birth cohort 1989 vs. 1.31% (1.14–1.51) birth cohort 1992) and grade II (0.61% (0.49–0.75) birth cohort 1989 vs. 0.52% (0.42–0.65) birth cohort 1992) remained stable.ConclusionsA decrease of the burden of anogenital disease potentially related to HPV was observed in the younger birth cohorts. This was observed especially for genital warts and anogenital diseases grade III. Further research to investigate this trend for the upcoming years in light of varying HPV vaccination coverage for newer birth cohorts is necessary.
Highlights
Most individuals are infected with human papillomavirus (HPV) at least once in their lifetime
By assessing the first three birth cohorts (1990–1992) who were fully eligible for HPV vaccination according to the first German Standing Committee on Vaccination [Ständige Impfkommission] (STIKO) recommendation and birth cohort 1989 which was partially eligible we aimed to generate insights into the burden of potentially HPV-related anogenital diseases in these specific birth cohorts after the introduction of the HPV vaccination in Germany
15,358, 16,027, 14,748 and 14,862 women were continuously insured at the age of 23 to 25, including women who deceased in this age period
Summary
Most individuals are infected with human papillomavirus (HPV) at least once in their lifetime. Infections with low-risk types can cause genital warts, whereas high-risk types can cause malignant tumors. Human papillomavirus (HPV) infection belongs to the most frequent sexually transmitted infections in men and women worldwide [1]. HPV types capable of infecting mucosal epithelia are subdivided into low-risk and high-risk types. Low-risk types HPV 6 and 11 are responsible for approximately 90% of all anogenital wart cases [4]. Several million cases of anogenital warts occur each year in both sexes, with a peak incidence between 20 and years of age for women and between and 29 years among men [5]. In Germany, a crude incidence rate of anogenital warts for women aged 10 to 79 years old was reported with 181 per 100,000 person years in 2010 [6]
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