Increasing Incidence of Anogenital Warts with an Urban–Rural Divide among Males in Manitoba, Canada, 1990–2011

Background

Anogenital warts (AGW) are caused by the most common sexually transmitted infection, human papillomavirus. The objective of this study was to examine AGW incidence from 1990 to 2011 by sex, age, income quintile, and residential area category (urban/rural). The study period included the initiation of school-based HPV vaccination for girls in the sixth grade, which began in 2008. The data presented in this paper may also be useful for establishing baseline rates of AGW incidence which may be used to evaluate the success of the school-based HPV immunization program.

Methods

Cases of anogenital warts were identified using Manitoba’s administrative databases of Physician Claims and Hospital Discharge Abstracts. Annual age-standardized incidence in Manitoba from 1990 to 2011 was calculated. Incident AGW rates were compared by sex, age group, residential area category (urban/rural), and household income quintile using logistic regression. Joinpoint regression analyses were used to evaluate the time trends of AGW.

Results

Prior to 2000, AGW incidence was higher among females than males. However, from 2000 to 2011 the incidence was higher among males and increased steadily over time. AGW incidence tended to peak in younger age groups among females compared to males. Females and males living in urban areas had nearly twice the odds of AGW occurrence compared to those in rural areas.

Conclusions

There is a need for education about AGW in male population. The upcoming initiation of HPV vaccination among boys may reduce the incidence and should be evaluated.

Below: Age-Standardized Incidence (per 100,000 persons) of AGW in Manitoba, 1990 – 2011

Below:  Sex Stratified Age-Specific 5-year Average AGW Incidence (per 100,000 persons) in Manitoba, 1990 – 2011

Below:  The Trends of Age-Standardized Incidence (per 100,000 persons) of AGW by Sex and Geographic Residential Area in Manitoba, 1990 - 2011

Full article at:   http://goo.gl/keXH9u

By:  Laura H. Thompson, Zoann Nugent, James F. Blanchard, Carla Ens, and Bo Nancy Yu*

Epidemiology and Surveillance Unit, Public Health and Primary Health Care Division, Manitoba Health, Healthy Living & Seniors, Winnipeg, R3B 3 M9 Manitoba Canada

Centre for Global Public Health, University of Manitoba, Winnipeg, Canada

Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada

Bo Nancy Yu, Email: ac.abotinamu@uy.ycnan.

*Corresponding author.

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Associations of Anogenital Low-Risk Human Papillomavirus Infection with Cancer and Acquisition of HIV

α-Mucosal human papillomavirus (HPV) types are implicated in a range of clinical conditions and categorized as "low-risk" (LR) and "high-risk" (HR) types according to their degree of association with cervical cancers. 

The causative role of LR HPV infection in the development of anogenital warts and in low-grade squamous intraepithelial lesions is well established. In addition, there is a growing body of evidence that infection with LR HPV types may be associated with an elevated risk of cancers and potentiation of coinfections. Prospective and case-control studies consistently report a higher risk of anogenital cancers in men and women with a history of anogenital warts. 

Based on currently available evidence, this higher risk may be due to shared exposure to HR HPV types or an underlying immune impairment, rather than a direct role of LR HPV types in subsequent cancer risk. Data also suggest that infection with LR HPV, HR HPV, or both may increase the risk of HIV acquisition, although the relative contribution of different HPV types is not yet known. There is also evidence implicating HPV clearance, rather than HPV infection, in increased risk of HIV acquisition.

Via:  http://ht.ly/Sybhc Purchase full article at: http://goo.gl/OrIwsI

By: Bennetts LE1, Wagner M, Giuliano AR, Palefsky JM, Steben M, Weiss TW.

• 1From the *LASER Analytica, Montréal, Québec, Canada; †H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; ‡Department of Medicine, University of California San Francisco, San Francisco, CA; §Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montréal, Québec, Canada; and ¶Merck & Co, Inc, Global Health Outcomes, West Point, PA. 
  
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