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Background: In late 2006 a quadrivalent human papillomavirus (HPV) vaccine for prevention of cervical cancer and anogenital warts was licensed for use in US females. Vaccination is recommended for girls aged 11-12, with catch-up vaccination through age 26. In 2009, HPV vaccine uptake among US girls aged 13-17 was 44.3% for 1 dose and 26.7% for 3 doses. Decreases in prevalence of anogenital warts may be among the earliest indicators of HPV vaccination impact.
Objectives: We estimated the prevalence of anogenital warts between 2003 and 2009 to detect potential decreases after 2006 among age groups most likely to be affected by HPV vaccination.
Methods: Health care claims data from >120 million privately insured individuals continuously enrolled within each year were examined. Genital wart diagnoses were derived using (1) a diagnosis of condyloma acuminata, or (2) a less specific viral wart diagnosis or genital wart medication, combined with either a benign anogenital lesion diagnosis or procedure specific for anogenital lesions within 30 days.
Results: Anogenital wart prevalence in both sexes was highest among those aged 15-39. In those males, prevalence for each 5-year age group increased between 2003 and 2009. However, among females prevalence during 2003-2009 increased only in those aged 25-39. Prevalence among females aged 15-19 increased from 2.4 to 2.9 per 1000 through 2006, then significantly declined to 2.2 in 2009. In women aged 20-24, prevalence increased from 4.0 to 5.5 in 2007, and then remained level through 2009.
Conclusions: These findings suggest that trends in anogenital wart prevalence changed in 2007-2009 among females aged 15-24, the group most likely to be impacted by the introduction of HPV vaccine.
Implications for Programs, Policy, and Research: Despite somewhat low HPV vaccination uptake, these data suggest that reductions in anogenital warts among US women may be occurring.