Kliewer Erich V, Demers Alain A, Elliott Lawrence, Lotocki Robert, Butler James R G, Brisson Marc
Department of Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Sex Transm Dis. 2009 Jun;36(6):380-6. doi: 10.1097/OLQ.0b013e318198de8c.
A vaccine has recently been licensed in many countries that protects against the human papillomavirus types 6, 11, 16, and 18. Types 6 and 11 account for approximately 90% of anogenital warts (AGWs). We describe the 20-year trends in the incidence and prevalence of AGWs in Manitoba, Canada.
We used linked population-based hospital and physician databases for Manitoba for 1984 to 2004. Cases were identified using tariff (billing) and ICD codes. A case was considered to be incident if it was preceded by a 12-month interval free period of AGWs care. Otherwise, it was deemed to be prevalent. An episode was considered over once a 12-month interval had elapsed without an AGW claim.
Approximately 25,000 Manitobans were diagnosed with AGWs between 1985 and 2004. The annual age-standardized incidence rates peaked in 1992 (men, 149.9/100,000; women 170.8/100,000). In recent years, the rates have been increasing again, particularly for men. The male:female incidence rate ratio increased from 0.76 in 1985 to 1.25 in 2004. The highest incidence rate tended to be in those aged 20 to 24 years. Trends in prevalence were similar. Prevalence in 2004 was 165.2/100,000 for men and 128.4/100,000 for women.
These population-based findings suggest that AGWs are a substantial burden to Manitobans and that their pattern has changed over time, with incidence and prevalence becoming higher in men than women. Monitoring the future trends in AGWs will provide an early marker of the effectiveness and duration of protection of human papillomavirus vaccination at a population level.
最近一种预防人乳头瘤病毒6、11、16和18型的疫苗已在许多国家获得许可。6型和11型约占肛门生殖器疣（AGW）的90%。我们描述了加拿大曼尼托巴省AGW发病率和患病率的20年趋势。
我们使用了1984年至2004年曼尼托巴省基于人群的医院和医生关联数据库。通过收费（计费）和国际疾病分类代码识别病例。如果病例之前有12个月的AGW护理无病期，则该病例被视为新发病例。否则，它被视为现患病例。一旦经过12个月的间隔且无AGW索赔，一个病程即被视为结束。
1985年至2004年间，约25000名曼尼托巴人被诊断患有AGW。年龄标准化发病率在1992年达到峰值（男性为149.9/10万；女性为170.8/10万）。近年来，发病率再次上升，尤其是男性。男女发病率之比从1985年的0.76增至2004年的1.25。发病率最高的往往是20至24岁的人群。患病率趋势相似。2004年男性患病率为165.2/10万，女性为128.4/10万。
这些基于人群的研究结果表明，AGW给曼尼托巴人带来了沉重负担，且其模式随时间发生了变化，男性的发病率和患病率高于女性。监测AGW的未来趋势将为人群层面人乳头瘤病毒疫苗接种的有效性和保护持续时间提供早期指标。
