Abstract
BackgroundHuman papillomavirus (HPV) is one of the most common sexually-transmitted pathogens. A number of studies in the literature have estimated the burden of HPV-related diseases by collecting data at primary care level, while a comprehensive assessment of the global burden of HPV-related diseases on hospital resources is still lacking.MethodsThis was a retrospective cohort study based on hospital discharge data collected from 2000 to 2010 in the Veneto Region (north-east Italy). All hospitalizations for diseases potentially associated with HPV were identified by searching the hospital discharge records, then the proportion of these hospitalizations relating to diseases attributable to the HPV infection was calculated.ResultsOverall, the annual hospitalization rate for HPV-related diseases was 21.3 per 100,000 individuals in the general population, 15.8 per 100,000 males, and 27.6 per 100,000 females. Hospitalizations were due mainly to genital warts, and peak among 15- to 44-year-olds in both genders. Taking both sexes together, the hospitalizations attributable to HPV dropped from 24.5/100,000 in 2000 to 17.5/100,000 in 2011, showing a significant decline during this period, with an average annual percent change (AAPC) of −1.9% (CI 95%: -2.8, -0.9;). On the other hand, the hospitalization rate for genital warts tended to increase significantly (AAPC 3.0% [CI 95%: 1.4;4.7]), whilst there was a significantly declining trend in the hospitalization rate for anal cancer (AAPC - 5.0% [CI 95%: -7.7;-2.2]), genital cancer (AAPC −6.2% [CI 95%: -7.8;-4.6]) and oropharyngeal cancer (AAPC −4.3% [CI 95%: -4.8;-3,8]).ConclusionData derived from the hospital records indicate that HPV-related diseases are an important public health issue.
Highlights
Human papillomavirus (HPV) is one of the most common sexually-transmitted pathogens
The proportion of hospitalizations for diseases potentially associated with HPV infection was calculated on the assumption that all discharges for cervical cancer and genital warts were HPVrelated, while this was true of 50% and 88%, respectively, of cancers of the male genitalia and anus, and applied to 26% of oropharyngeal cancers [7,8,9]
It is computed as a weighted average of the annual percent change (APC) emerging from the join-point model, using weights equating to the length of the APC interval
Summary
A number of studies in the literature have estimated the burden of HPV-related diseases by collecting data at primary care level, while a comprehensive assessment of the global burden of HPV-related diseases on hospital resources is still lacking. Human papillomavirus (HPV) is the most common sexually-transmitted pathogen [1]. In the USA, more than one in two sexually-active individuals become infected with one or more types of HPV at some point in their lives. The estimated overall epidemiological burden of HPV-related cancers and non-malignant diseases is very high in Europe too [4]. Most infections are asymptomatic and transient, but certain HPV types are oncogenic. Numerous studies have identified many biochemical features that contribute to HPV-induced carcinogenesis, such as the ability of the viral proteins E6 and E7 to bind cellular factors, and biological properties like the capacity of HPV proteins to induce cell immortalization [5]
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