title: Prevalence of genital human papillomavirus among men in Europe: systematic review and meta-analysis.
abstract: BACKGROUND
  Human papillomavirus (HPV) is the commonest sexually transmitted infection worldwide and causes substantial morbidity in both sexes. Most European countries offer HPV vaccination for girls, but vaccine recommendations for boys are warranted.
  
  
  OBJECTIVE
  The aims of this study were to investigate the prevalence of genital HPV, identify parameters that affect the prevalence, and describe the type-specific prevalence among men in Europe.
  
  
  METHODS
  A systematic review and meta-analysis of the published literature in PubMed and Embase.
  
  
  METHODS
  Genital HPV prevalence and factors influencing prevalence in general and high-risk male populations in Europe.
  
  
  RESULTS
  We included 31 articles that gave the prevalence of genital HPV DNA among men in northern, southern and western Europe; no studies from eastern Europe were identified. The pooled HPV prevalence among 1,863 men representing the general population (nine studies) was 12.4%, with large heterogeneity between studies (I(2)  = 96.3%, P < 0.0001). The pooled HPV prevalence among 6,428 men in the high-risk population (22 studies) was 30.9%, also with substantial heterogeneity (I(2)  = 95.6%, P < 0.0001). In unadjusted meta-regression analysis, the HPV prevalence in the general population was significantly higher in studies published after 2000 (28.5%) than in earlier studies (8.8%) (P = 0.0179). In the meta-regression analysis adjusted by publication year, the heterogeneity in the two population groups could not be explained by geographical region, anatomical sampling site, or HPV detection method. HPV16 was the most prevalent high-risk type in both populations.
  
  
  CONCLUSIONS
  HPV prevalence differs in male general and high-risk populations, but HPV16 and HPV18 are among the most common HPV types detected in both groups. Our findings contribute knowledge that may be useful as a baseline measure before the introduction of HPV vaccination for boys in Europe, and add to understanding of the epidemiology of HPV infection in men.
authors.affiliation: Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Julie B
authors.initials: JB
authors.lastname: Hebnes
authors.forename: Tina B
authors.initials: TB
authors.lastname: Olesen
authors.forename: Anne Katrine
authors.initials: AK
authors.lastname: Duun-Henriksen
authors.forename: Christian
authors.initials: C
authors.lastname: Munk
authors.forename: Bodil
authors.initials: B
authors.lastname: Norrild
authors.forename: Susanne K
authors.initials: SK
authors.lastname: Kjaer
mesh_terms: D005060:Europe / Q000453:epidemiology; D005260:Female; D005832:Genital Diseases, Male / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000150:complications
keywords: Europe; Genital; Human Papillomavirus; Men; Meta-Analysis; Systematic Review