The incidence, clearance and persistence of non-cervical human papillomavirus infections: a systematic review of the literature.
Human papillomavirus (HPV) vaccines were designed to prevent cervical cancer in women and their provision remains a major public health need. However, HPV is also a major cause of non-cervical anogenital and oropharyngeal cancers and the potential benefit of vaccination likely extends beyond cervical cancer.



A systematic literature search of PubMed (1995-2014) identified publications assessing the incidence, persistence, and clearance of non-cervical anogenital/oral HPV infections. Comparability with cervical HPV was assessed by identifying articles assessing the same or similar populations.



Available data suggest high incidence rates of non-cervical HPV infection in men and women, with HPV-16 predominating in all sites. The incidence of high risk HPV per 100 person-years ranged from 11.4 to 72.9 for penile infections, 6.7-47.9 at other male genital sites, and 4.4-36.7 and 5.3-23.4 for anal infections in men and women, respectively. The incidence per 100 person-years of oral infection with any HPV type ranged from 5.7 to 6.7 in men and 6.8-39.6 in women. Within the limitations of the data, there was a general pattern of higher incidence and clearance of non-cervical genital HPV infections, compared to cervical infections. HIV status, circumcision, number of sex partners and partner HPV status significantly influenced high-risk HPV incidence/clearance at male anogenital sites. Few studies assessed risk factors for oral HPV.



Parallels appear to exist between the epidemiology of cervical and non-cervical HPV infections in terms of incidence, HPV-type distribution, and risk factors for infection. Available data suggest that non-cervical genital HPV infections may occur more frequently, with higher clearance rates, than cervical infections. More extensive studies could provide useful information for estimating vaccine impact, the wider cost-benefit of HPV vaccination, and guiding vaccination policy.



Not applicable, as systematic review of the literature.
GSK Vaccines, 20, Avenue Fleming, Parc de la Noire Epine, B-1300, Wavre, Belgium. sylvia.m.taylor@gsk.com.
Sylvia
S
Taylor
Pallas Health Research and Consultancy BV, Rotterdam, The Netherlands.
Eveline
E
Bunge
Pallas Health Research and Consultancy BV, Rotterdam, The Netherlands.
Marina
M
Bakker
Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, Catalonia, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Xavier
X
Castellsagué
D001004:Anus Diseases / Q000453:epidemiology* / Q000821:virology; D005260:Female; D005832:Genital Diseases, Male / Q000453:epidemiology* / Q000821:virology; D052162:Human papillomavirus 16; D006801:Humans; D015994:Incidence; D008297:Male; D009059:Mouth Diseases / Q000453:epidemiology* / Q000821:virology; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D053918:Papillomavirus Vaccines; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000821:virology; D014623:Vaginal Diseases / Q000453:epidemiology* / Q000821:virology
D053918:Papillomavirus Vaccines
Cervical; Clearance; Human papillomavirus; Incidence; Oral; Penile; Persistence; Systematic review; Vaginal