Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea.
Cancer Risk Appraisal and Prevention Branch, National Cancer Center, Goyang, Republic of Korea.
Sex Transm Infect. 2019 Jun;95(4):292-299. doi: 10.1136/sextrans-2018-053742. Epub 2019 Jan 24.
We aimed to evaluate trends in the prevalence of human papillomavirus (HPV)-related diseases in the era before the introduction of organised HPV vaccination programmes in the Republic of Korea.
This cross-sectional study used National Health Insurance Service data from 2002 to 2015 and included participants who were diagnosed with the following HPV-related diseases (codes from the International Classification of Diseases, 10th Revision): genital warts (A63.0); cancer in the head and neck (C00-C10), anus (C21), vulva (C51), vagina (C52), cervix uteri (C53) and penis (C60); carcinoma in situ (CIS) of the lip/oral cavity/pharynx (D00.0), anus (D01.3), cervix (D06), vulva (D07.1), vagina (D07.2) and penis (D07.4); benign neoplasms of the larynx (D14.1); and dysplasia of the cervix (N87), vagina (N89) and vulva (N90). For each diagnosis, the fraction of cases attributable to HPV in Korea was assessed based on the percentages of diseases attributable to HPV reported in some international studies. The age-standardised prevalence was estimated using the direct population-based method.
The overall age-standardised prevalence of HPV-related diseases increased from 2002 to 2015, mainly due to increased prevalence of genital warts in men and cervical dysplasia and CIS in women. In women, genital wart prevalence increased from 2002 (24.4 per 100 000) to 2011 (57.1) and then decreased until 2015 (53.5); in men, the prevalence increased steadily from 2002 (22.9) to 2015 (109.4). The prevalence of cervical dysplasia and CIS increased (from 86.5 in 2002 to 484.5 in 2015, and from 60.3 in 2002 to 114.9 in 2015, respectively), but that of cervical cancer decreased (from 120.0 in 2002 to 106.9 in 2015).
Non-organised HPV vaccination and organised cervical cancer screening may have contributed to the downward trend in genital wart prevalence and the upward trend in cervical abnormalities among women.
本研究旨在评估在韩国引入 HPV 疫苗接种计划之前， HPV 相关疾病的流行趋势。
本横断面研究使用了 2002 年至 2015 年的国家健康保险服务数据，并纳入了以下 HPV 相关疾病的参与者（国际疾病分类第 10 版代码）：生殖器疣（A63.0）；头颈部癌症（C00-C10）、肛门（C21）、外阴（C51）、阴道（C52）、子宫颈（C53）和阴茎（C60）；唇/口腔/咽（D00.0）、肛门（D01.3）、子宫颈（D06）、外阴（D07.1）、阴道（D07.2）和阴茎（D07.4）的原位癌（CIS）；喉良性肿瘤（D14.1）；宫颈（N87）、阴道（N89）和外阴（N90）的发育不良。对于每种诊断，根据一些国际研究报告的 HPV 相关疾病百分比，评估了 HPV 在韩国的发病比例。使用直接人口基础法估计年龄标准化患病率。
2002 年至 2015 年，HPV 相关疾病的总体年龄标准化患病率呈上升趋势，主要是由于男性生殖器疣和女性宫颈发育不良和 CIS 患病率增加所致。在女性中，生殖器疣的患病率从 2002 年（每 100000 人 24.4 例）增加到 2011 年（57.1），然后在 2015 年减少到 53.5；男性患病率从 2002 年（22.9）稳步上升到 2015 年（109.4）。宫颈发育不良和 CIS 的患病率增加（分别从 2002 年的 86.5 增加到 2015 年的 484.5 和从 2002 年的 60.3 增加到 2015 年的 114.9），而宫颈癌的患病率下降（从 2002 年的 120.0 减少到 2015 年的 106.9）。
非组织性 HPV 疫苗接种和组织性宫颈癌筛查可能导致生殖器疣患病率下降，以及女性宫颈异常率上升。
