Human Papillomavirus Prevalence in the U.S.

Human Papillomavirus Prevalence in the U.S.

It’s even higher than we thought.

Human papillomavirus (HPV) is a common, sexually transmitted infection known to cause cervical cancer. In 2006, the first HPV vaccine, which is highly efficacious against HPV types 6, 11, 16, and 18, was licensed by the FDA. New guidelines from the Advisory Committee on Immunization Practices recommend the vaccine for girls aged 11 to 12 years, before most girls become sexually active. To determine the population-based prevalence of HPV infection, CDC investigators analyzed self-collected vaginal swabs by polymerase chain reaction (PCR) from 2026 females aged 14 to 59 years who participated in the 2003–2004 National Health and Nutrition Examination Survey.

For all age groups combined, the prevalence of HPV was 26.8%. The prevalence significantly increased with age from 14 to 24 years and then declined gradually through age 59. The highest overall prevalence (44.8%) was among women ages 20 to 24 years. In multivariate analysis, factors associated with a positive HPV-PCR result were age younger than 25 years, unmarried status, and increasing number of recent or lifetime sexual partners. HPV types 16 and 18, which cause about 70% of cervical cancers, were identified in 1.5% and 0.8% of samples, respectively.

Comment: These findings indicate that the prevalence of HPV is even higher than previous estimates. Although the prevalence of high-risk HPV types was lower in this study than in prior studies, the variance might reflect differences between using vaginal swabs (which estimate cervical infection) and antibody testing (which estimates HPV exposure). The low rate of high-risk HPV types does not change my enthusiasm for the new vaccine, which shows great promise in preventing many cases of cervical cancer. The high overall HPV prevalence underscores the need for prevention.

— Peggy Sue Weintrub, MD

Published in Journal Watch Pediatrics and Adolescent Medicine March 28, 2007