Patterns of Treatment of External Genital Warts in Australian Sexual Health Clinics

Pirotta, Marie; Stein, Alicia; Fairley, Christopher K.; Morrow, Andrea; Conway, Elizabeth L; Chuah, John; McCloskey, Jenny; McNulty, Anna; Waddell, Russell; Carter, Rob; Garland, Suzanne M.

doi:10.1097/olq.0b013e3181971e4e

Cited by 20 publications

(17 citation statements)

References 19 publications

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“…For this disease, the hospitalization rate peaked for men slightly later in life than for women (at 25–44 years of age in the former and 15–24 in the latter). Our figures are similar to those reported in North American and Australian studies [18], whereas the peak age was the same for the two genders in the United Kingdom and Nordic countries [19,20]. …”

Section: Discussionsupporting

confidence: 91%

“…This might suggest a gender-related difference in the natural history of HPV, with lower infection and higher disease rates in women, and vice versa in men [17,18]. The age groups considered in our sample revealed age-related differences in the hospitalization rates for the diseases examined: more older people had cancer and more younger people had condylomatosis.…”

Section: Discussionmentioning

confidence: 97%

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Hospitalization for diseases attributable to human papillomavirus in the Veneto Region (North-East Italy)

et al. 2013

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BackgroundHuman papillomavirus (HPV) is one of the most common sexually-transmitted pathogens. A number of studies in the literature have estimated the burden of HPV-related diseases by collecting data at primary care level, while a comprehensive assessment of the global burden of HPV-related diseases on hospital resources is still lacking.MethodsThis was a retrospective cohort study based on hospital discharge data collected from 2000 to 2010 in the Veneto Region (north-east Italy). All hospitalizations for diseases potentially associated with HPV were identified by searching the hospital discharge records, then the proportion of these hospitalizations relating to diseases attributable to the HPV infection was calculated.ResultsOverall, the annual hospitalization rate for HPV-related diseases was 21.3 per 100,000 individuals in the general population, 15.8 per 100,000 males, and 27.6 per 100,000 females. Hospitalizations were due mainly to genital warts, and peak among 15- to 44-year-olds in both genders. Taking both sexes together, the hospitalizations attributable to HPV dropped from 24.5/100,000 in 2000 to 17.5/100,000 in 2011, showing a significant decline during this period, with an average annual percent change (AAPC) of −1.9% (CI 95%: -2.8, -0.9;). On the other hand, the hospitalization rate for genital warts tended to increase significantly (AAPC 3.0% [CI 95%: 1.4;4.7]), whilst there was a significantly declining trend in the hospitalization rate for anal cancer (AAPC - 5.0% [CI 95%: -7.7;-2.2]), genital cancer (AAPC −6.2% [CI 95%: -7.8;-4.6]) and oropharyngeal cancer (AAPC −4.3% [CI 95%: -4.8;-3,8]).ConclusionData derived from the hospital records indicate that HPV-related diseases are an important public health issue.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 97%

Hospitalization for diseases attributable to human papillomavirus in the Veneto Region (North-East Italy)

et al. 2013

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“…In contrast, more women (16% vs 8%) are referred to specialists, and 76% of ablative procedures requiring hospitalisation are performed in women. This is consistent with a previous report on GP management of sexually transmitted infections based on an earlier analysis of the BEACH database26 but contrasts with our previous research in sexual-health clinics24 where ablative treatments are performed in similar proportions of men and women, with very few patients referred on to other services (∼1.5%), reflecting the specialised nature of such clinics. Patient purchased topical treatments for GW are prescribed or recommended in ∼24% of GP consultations, with similar rates of prescription of imiquimod and podophyllum resin based treatments.…”

Section: Discussionsupporting

confidence: 87%

“…Peak ages for Australian GW patients seeking treatment from GPs (20–24 years in women and 25–29 years in men) are comparable with those attending sexual-health clinics24 and are similar to those in the US21 and Canada,19 whereas in the UK and Nordic countries, 20–24 years is the peak age for both genders 4 25…”

Section: Discussionmentioning

confidence: 61%

Genital warts incidence and healthcare resource utilisation in Australia

Pirotta

Stein

Conway

et al. 2009

Sexually Transmitted Infections

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Objectives To estimate for the first time the incidence and healthcare resource utilisation associated with genital warts (GW) in Australia prior to the human papillomavirus vaccination programme. Method The authors analysed data from the nationally representative Bettering the Evaluation of Care and Health general practice cross-sectional programme and from the National Hospital Morbidity Database to estimate age-related incidence and community (nonhospital) and hospital-related costs (in 2009 Australian dollars) associated with medical treatment of GW. Results The authors estimated an annual incidence of 2.19 cases of GW per 1000 Australians (95% CI 1.88 to 2.49), with peak incidence in women aged 20e24 years at 8.61 cases per 1000 and in men aged 25e29 years at 7.40 cases per 1000. The estimated number of consultations per GW case was 2.9 (95% CI 2.5 to 3.3) for women and 2.8 (95% CI 2.3 to 3.2) for men. Ablative treatments in general practice were more common in men (60% of consultations) than in women (37% of consultations). In contrast, more women (16% vs 8%) were referred to specialists, and 75% of ablative procedures requiring hospitalisation were performed in women. The annual cost of management of GW is over A $14 million, with an estimated cost per treated case of A $251 for men and A$386 for women. Conclusions GW impose a large health and cost burden on Australians. The national immunisation programme with the quadrivalent human papillomavirus vaccine has the potential to greatly reduce this burden, and future research measuring its impact is keenly anticipated.

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“…Previous studies estimated the incidence of AGW for Australia [13,19,26], Canada [14,16], United States [15,27], UK [9,10], Italy [18], Spain [19], France [28], and Germany [12]. While due to the use of different data sources, study methods and reporting of the incidence for various age ranges a direct comparison is difficult, some observations can be made.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2010

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BackgroundHuman 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.MethodsRetrospective 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.ResultsThe 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%).ConclusionsIncidence 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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Patterns of Treatment of External Genital Warts in Australian Sexual Health Clinics

Cited by 20 publications

References 19 publications

Hospitalization for diseases attributable to human papillomavirus in the Veneto Region (North-East Italy)

Hospitalization for diseases attributable to human papillomavirus in the Veneto Region (North-East Italy)

Genital warts incidence and healthcare resource utilisation in Australia

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

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