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. 2010 Dec 23:10:360.
doi: 10.1186/1471-2334-10-360.

Incidence of anogenital warts in Germany: a population-based cohort study

Angela A Kraut  1 , Tania Schink, Renate Schulze-Rath, Rafael T Mikolajczyk, Edeltraut Garbe
Affiliations

Incidence of anogenital warts in Germany: a population-based cohort study

Angela A Kraut et al. BMC Infect Dis. .

Abstract

Background: Human papilloma virus (HPV) types 6 and 11 account for 90 percent of anogenital warts (AGW). Assessment of a potential reduction of the incidence of AGW following introduction of HPV vaccines requires population-based incidence rates. The aim of this study was to estimate incidence rates of AGW in Germany, stratified by age, sex, and region. Additionally, the medical practitioner (gynaecologist, dermatologist, urologist etc.) who made the initial diagnosis of AGW was assessed.

Methods: Retrospective cohort study in a population aged 10 to 79 years in a population-based healthcare insurance database. The database included more than 14 million insurance members from all over Germany during the years 2004-2006. A case of AGW was considered incident if a disease-free period of twelve months preceded the diagnosis. To assess regional variation, analyses were performed by federal state.

Results: The estimated incidence rate was 169.5/100,000 person-years for the German population aged 10 to 79 years. Most cases occurred in the 15 to 40 years age group. The incidence rate was higher and showed a peak at younger ages in females than in males. The highest incidence rates for both sexes were observed in the city-states Berlin, Hamburg and Bremen. In females, initial diagnosis of AGW was most frequently made by a gynaecologist (71.7%), whereas in males, AGW were most frequently diagnosed by a dermatologist (44.8%) or urologist (25.1%).

Conclusions: Incidence of AGW in Germany is comparable with findings for other countries. As expected, most cases occurred in the younger age groups. The frequency of diagnoses of AGW differs between sexes and women and men receive treatment by doctors of different specialties.

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Figures

Figure 1
Figure 1
Incidence rates of anogenital warts by 5 year age groups in males and females for Germany in 2005 to 2006.
Figure 2
Figure 2
Geographical variation in incidence rates of anogenital warts in Germany 2005 to 2006. Note: Incidence rates are standardised for the sex and age distribution of the German population in 2006 and are computed per 100,000 person-years. Bremen and Bremerhaven constitute the city-state Bremen.
Figure 3
Figure 3
Crude incidence rates of anogenital warts for regions in Germany in 2005 to 2006 by sex. City-states: the Federal states Berlin, Bremen and Hamburg. West Germany: Federal states belonging to former West Germany without city-states. East Germany: Federal states belonging to former East Germany without city-states.
Figure 4
Figure 4
Initial diagnosis of anogenital warts by specialty of medical practitioner (2005 to 2006). Note: hospital diagnoses are not classified by specialties. * The medical practitioner who made the first diagnosis could not be ascertained because more than one medical practitioner made a diagnosis in the respective quarter. † Ambulatory diagnoses made by medical practitioners with other specialties than those listed.
See this image and copyright information in PMC

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