Incidence rates of anogenital warts in Germany

Background: Human papilloma virus (HPV) types 6 and 11 account for 90% of anogenital warts (AGW). Representative data for the German population on incidence rates of AGWs are lacking. Objectives of this study were to estimate the incidence rate of AGW in Germany from 2005 to 2006, stratified by age, sex, and region, and to determine the specialty of physician who made the initial diagnosis and type of drug treatment received. Methods: Age and sex standardised (for the German population 2006) incidence rates were estimated in an historical cohort ascertained from a population-based, large healthcare insurance database including more than 14 million insurants from all over Germany. A case was considered incident if a disease-free period of twelve months preceded the diagnosis of AGW. Descriptive analyses were conducted as to the specialty of the first diagnosing physician and drug treatment received. Results: The standardised incidence rate was 170/100,000 person years (py) in the age group 10–79. In the high risk age group (18–35 years), the incidence was 409/100,000 py in 2006 (406/100,000 py in 2005). The incidence rate was higher in females than in males below the age of 30 years and showed a peak at younger ages. The highest incidence rates were observed in the city states Berlin, Hamburg and Bremen. In females, initial diagnosis of AGW was most frequently made by gynaecologists (72%), whereas in males, AGW were most frequently diagnosed by dermatologists (45%) and urologists (25%). Women were most frequently treated with imiquimod cream (60% of those with specific treatment codes), whereas men received more often podophyllotoxin (57%). Conclusions: Incidence of AGW in Germany is in the range of findings for other countries. More frequent diagnosis of AGW among young women might occur in the context of yearly screening, while men have to seek treatment actively.