Estimating the prevalence of and treatment patterns for juvenile onset recurrent respiratory papillomatosis in Australia pre-vaccination: a pilot study.
BACKGROUND
Recurrent respiratory papillomatosis (RRP) causes serious morbidity. RRP in Australia may be eliminated in the near future following the implementation of a national vaccination program using a human papillomavirus (HPV) vaccine that protects against infection with HPV types 6 and 11, those responsible for RRP. Baseline data on RRP prevalence and disease burden in Australia are lacking.


METHODS
Three study methods were used to estimate the burden of juvenile onset RRP in Australia. We conducted a retrospective chart review of RRP cases treated at The Children's Hospital at Westmead over 10 years, examined the coding of these cases, and then calculated and applied the positive predictive value of the codes to national data to estimate the prevalence of RRP in Australia. We also conducted an online survey of otolaryngologists in Australia who manage RRP.


RESULTS
Nineteen patients were treated at the hospital over 10 years, involving 359 admissions. We estimate that between 33 and 56 RRP cases aged <20 are being treated nationally per year (0.6-1.1 per 100 000 persons), with children 5-9 years having a higher estimated rate of 1.2-1.8 per 100 000. Among 39 otolaryngologists treating juvenile onset RRP, the majority (73%) treated RRP in a paediatric tertiary hospital, and used the microdebrider for ablation of lesions.


CONCLUSIONS
Our estimates of RRP disease burden agree with international estimates. As a small number of clinicians treat RRP nationally, we believe that establishment of a national RRP register is both feasible and necessary to monitor the impact of vaccination.
Novakovic
Daniel
D
St Luke's Roosevelt Hospital, New York, NY 10019, USA.
Cheng
Alan T L
AT
Cope
Daron H
DH
Brotherton
Julia M L
JM
D000293:Adolescent; D000328:Adult; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D052140:Human papillomavirus 11; D052163:Human papillomavirus 6; D006801:Humans; D015994:Incidence; D007223:Infant; D007828:Laryngoscopy / Q000706:statistics & numerical data; D008297:Male; D010039:Otorhinolaryngologic Neoplasms / Q000453:epidemiology* / Q000517:prevention & control / Q000601:surgery; D010212:Papilloma / Q000453:epidemiology* / Q000517:prevention & control / Q000601:surgery; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D010343:Patient Admission / Q000706:statistics & numerical data; D010865:Pilot Projects; D011159:Population Surveillance; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult
D053918:Papillomavirus Vaccines