Incidence of anogenital warts in Germany: a population-based cohort study.

Angela A Kraut,Edeltraut Garbe,Renate Schulze-Rath,Tania Schink,Rafael T Mikolajczyk

doi:10.1186/1471-2334-10-360

Abstract

BackgroundHuman papilloma virus (HPV) types 6 and 11 account for 90 percent of anogenital warts (AGW). Assessment of a potential reduction of the incidence of AGW following introduction of HPV vaccines requires population-based incidence rates. The aim of this study was to estimate incidence rates of AGW in Germany, stratified by age, sex, and region. Additionally, the medical practitioner (gynaecologist, dermatologist, urologist etc.) who made the initial diagnosis of AGW was assessed.MethodsRetrospective cohort study in a population aged 10 to 79 years in a population-based healthcare insurance database. The database included more than 14 million insurance members from all over Germany during the years 2004-2006. A case of AGW was considered incident if a disease-free period of twelve months preceded the diagnosis. To assess regional variation, analyses were performed by federal state.ResultsThe estimated incidence rate was 169.5/100,000 person-years for the German population aged 10 to 79 years. Most cases occurred in the 15 to 40 years age group. The incidence rate was higher and showed a peak at younger ages in females than in males. The highest incidence rates for both sexes were observed in the city-states Berlin, Hamburg and Bremen. In females, initial diagnosis of AGW was most frequently made by a gynaecologist (71.7%), whereas in males, AGW were most frequently diagnosed by a dermatologist (44.8%) or urologist (25.1%).ConclusionsIncidence of AGW in Germany is comparable with findings for other countries. As expected, most cases occurred in the younger age groups. The frequency of diagnoses of AGW differs between sexes and women and men receive treatment by doctors of different specialties.

Highlights

Human papilloma virus (HPV) types 6 and 11 account for 90 percent of anogenital warts (AGW)
A tetravalent vaccine against HPV 6, 11, 16 and 18 which protects against AGW and other manifestations of HPV infection has been approved by the European Medicines Agency (EMA) in 2006 [7]
When the incidence was further stratified by age, females had higher incidence rates of AGW than males in the younger age groups, with very little difference after the age of 30 years (Figure 1)

Summary

Introduction

Human papilloma virus (HPV) types 6 and 11 account for 90 percent of anogenital warts (AGW). Assessment of a potential reduction of the incidence of AGW following introduction of HPV vaccines requires population-based incidence rates. Anogenital warts (AGW) are a clinical manifestation of human papillomavirus (HPV) infection. More than 100 HPV types have been recognised so far, of which more than 40 can infect the anogenital tract [1,2]. HPV type 6 and in a smaller proportion type 11 account for 90 percent of AGW [4,5,6]. A tetravalent vaccine against HPV 6, 11, 16 and 18 which protects against AGW and other manifestations of HPV infection has been approved by the European Medicines Agency (EMA) in 2006 [7]

Objectives

Methods

Results

Discussion

Conclusion