Human papillomavirus epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Genital HPV Prevalence in the United States

Quoted statistics of HPV infection vary, with one review finding reported values anywhere from 14% to 90%.[1] The major reason numbers conflict is simply a lack of context. A report of the number of women that have ever been infected by any type will be much higher than the number that are currently infected by one of the high-risk types. The confusion surrounding the issue is highlighted by news coverage of a comprehensive study published in February 2007. Some headlines read "more women than expected have HPV", while others said that infection was "rarer than first estimated".[2][3] Both are actually true, in context:

The study found that, during 2003–2004, at any given time, 26.8% of women aged 14 to 59 were infected with at least one type of HPV. This was higher than previous estimates. Of the four types prevented by the Gardasil vaccine, however, only 3.4% were infected, which was lower than previous estimates. Of the high-risk types that cause cancer, 15.2% were infected.[4]

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.[5]

The American Social Health Association projections in 2006 were yet more pessimistic, predicting that about 75% of the reproductive population will have been infected with genital HPV infection in their lifetime.[6] Studies show that HPV infection is much more prevalent in the gay community. Studies show a link between HPV infection and penile and anal cancer, and the risk for anal cancer is 17 to 31 times higher among gay and bisexual men than among heterosexual men.[7][8]

Although it is possible to test for HPV DNA in men,[9] there are no FDA-approved tests for general screening, since the testing is inconclusive and considered medically unnecessary.[7][10]

There is no screening test for HPV infection in men. However, although there are no formal guidelines, some experts believe that men who receive anal sex should have a routine anal Pap test, especially if they also have HIV infection. Ask your health professional whether and how often you should be tested.[11]

Information from the CDC

According to the Centers for Disease Control (CDC), by the age of 50 more than 80% of American women will have contracted at least one strain of genital HPV. All women are encouraged to get a yearly pap smear solely to detect cellular abnormalities caused by HPV.[12]

Genital HPV is the most common sexual transmitted infection in the United States. About 6.2 million Americans will get infected with genital HPV this year. According to the National Cervical Cancer Coalition (NCCC), 11% of American women do not have regular cervical cancer screenings; women who do not have cervical cancer screenings on a regular basis dramatically increase their chances of developing cervical cancer. About 14,000 women in the United States are diagnosed with cervical cancer disease each year, and more than 3,900 women die in the United States each year from this disease.

Information from the AMA

According to the Journal of the American Medical Association (Dunne, Eileen F. et al, 2007) the prevalence of HPV infection among females in the United States is as follows:[4]

  • 24.5% prevalence of HPV among females 14 to 19 years old
  • 44.8% prevalence of HPV among females 20 to 24 years old
  • 27.4% prevalence of HPV among females 25 to 29 years old
  • 27.5% prevalence of HPV among females 30 to 39 years old
  • 25.2% prevalence of HPV among females 40 to 49 years old
  • 19.6% prevalence of HPV among females 50 to 59 years old

References

  1. Revzina NV, Diclemente RJ (2005). "Prevalence and incidence of human papillomavirus infection in women in the USA: a systematic review". International journal of STD & AIDS. 16 (8): 528–37. doi:10.1258/0956462054679214. PMID 16105186."The prevalence of HPV reported in the assessed studies ranged from 14% to more than 90%."
  2. McCullough, Marie (2007-02-28). "Cancer-virus strains rarer than first estimated". The Philadelphia Inquirer. Retrieved 2007-03-02. Check date values in: |date= (help)
  3. Brown, David (2007-02-28). "Study finds more women than expected have HPV". San Francisco Chronicle. Retrieved 2007-03-02. Check date values in: |date= (help) (originally published in the Washington Post as "More American Women Have HPV Than Previously Thought")
  4. 4.0 4.1 Dunne EF, Unger ER, Sternberg M; 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.
  5. 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."
  6. "American Social Health Association - HPV Resource Center". Retrieved 2007-08-17.
  7. 7.0 7.1 "STD Facts - HPV and Men". Retrieved 2007-08-17.
  8. Frisch M, Smith E, Grulich A, Johansen C (2003). "Cancer in a population-based cohort of men and women in registered homosexual partnerships". Am. J. Epidemiol. 157 (11): 966–72. PMID 12777359. However, the risk for invasive anal squamous carcinoma, which is believed to be caused by certain types of sexually transmitted human papillomaviruses, notably type 16, was significantly 31-fold elevated at a crude incidence of 25.6 per 100,000 person-years.
  9. Dunne EF, Nielson CM, Stone KM, Markowitz LE, Giuliano AR (2006). "Prevalence of HPV infection among men: A systematic review of the literature". J. Infect. Dis. 194 (8): 1044–57. doi:10.1086/507432. PMID 16991079.
  10. "What Men Need to Know About HPV". 2006. Retrieved 2007-04-04. There is currently no FDA-approved test to detect HPV in men. That is because an effective, reliable way to collect a sample of male genital skin cells, which would allow detection of HPV, has yet to be developed.
  11. "WebMD -- Error 404". Retrieved 2007-08-17.
  12. "STD Facts - HPV Vaccine". 2006-08-01. Retrieved 2007-08-17.

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