Estimated prevalence and incidence of disease-associated HPV types among 15-59-year-olds in the United States.

Abstract

INTRODUCTION\nHuman papillomavirus (HPV) can cause anogenital warts and several types of cancer, including cervical cancers and precancers. We estimated the prevalence, incidence, and number of persons with prevalent and incident HPV infections in the United States in 2018.\n\n\nMETHODS\nPrevalence and incidence were estimated for infections with any HPV (any of 37 types detected using Linear Array) and disease-associated HPV, two types that cause anogenital warts plus 14 types detected by tests used for cervical cancer screening (HPV 6/11/16/18/31/33/35/39/45/51/52/56/58/59/66/68). We used the 2013-2016 National Health and Nutrition Examination Survey to estimate prevalence among 15-59-year-olds, overall and by sex. Incidences in 2018 were estimated per 10,000 persons using an individual-based transmission-dynamic type-specific model calibrated to US data. We estimated number of infected persons by applying prevalences and incidences to 2018 US population estimates.\n\n\nRESULTS\nPrevalence of infection with any HPV was 40.0% overall, 41.8% in males and 38.4% in females; prevalence of infection with disease-associated HPV was 24.2% in males and 19.9% in females. An estimated 23.4 and 19.2 million males and females had a disease-associated HPV type infection in 2018. Incidences of any and disease-associated HPV infection were 1222 and 672 per 10,000 persons; incidence of disease-associated HPV infection was 708 per 10,000 males and 636 per 10,000 females. An estimated 6.9 and 6.1 million males and females had an incident infection with a disease-associated HPV type in 2018.\n\n\nCONCLUSIONS\nWe document a high HPV burden of infection in the United States in 2018, with 42 million persons infected with disease-associated HPV and 13 million persons acquiring a new infection. While most infections clear, some disease-associated HPV type infections progress to disease. The HPV burden highlights the need for continued monitoring of HPV-associated cancers, cervical cancer screening, and HPV vaccination to track and prevent disease.