EPIDEMIOLOGY OF GENITAL HUMAN PAPILLOMAVIRUS INFECTION

Recent clinical research has suggested a link between specific human papillomavirus types and the development of cancers of the genital tract and anus; however, supportive epidemiologic data are not well developed. In both the US and the UK, condylomata acuminata is the most commonly diagnosed viral sexually transmitted disease. The highest incidence is among females 20-24 years of age. The results of 6 studies to examine the prevalence of human papillomavirus suggest a rate of 1-13%, with a positive association to the prevalence of cervical intraepithelial neoplasia in that population. It is estimated that genital human papillomavirus infection has a 10% prevalence among men and women in the US 15-49 years of age: 1% have condylomata, 2% have lesions visible only by magnification with the colposcope or hand lens, and 7% have clinically inapparent infections. Human papillomavirus types 6 and 11 tend to cause condylomata and low-grade epithelial cell atypia, while types 16, 18, and 31 have been found in higher-grade intraepithelial neoplasia and invasive cervical cancers. Current evidence suggests a long latency between acquisition of genital papillomavirus infection and the development of cervical malignancy, with cervical cancer generally not developing until the 5th decade and beyond. From an epidemiologic point of view, the current research literature lacks evidence of careful selection and definition of study populations, consistent quality control of clinical and laboratory methods, and thorough statistical analyses. To make it more possible to compare the results of different studies, more attention to epidemiologic factors is needed.