Burden of HPV related anogenital diseases in young women in Germany – an analysis of German statutory health insurance claims data from 2012 to 2017

Reuschenbach, Miriam; Mihm, Sarah; Wölle, Regine; Schneider, Kim Maren; Jacob, Christian; Braun, Sebastian; Greiner, Wolfgang; Hampl, Monika

doi:10.1186/s12879-020-05002-w

Cited by 12 publications

(10 citation statements)

References 21 publications

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“…Eine weitere Studie unter Verwendung von Versichertendaten von ca. 60.000 jungen Frauen zeigte einen signifikanten Rückgang von zervikalen Läsionen und Genitalwarzen [60]. Die Prävalenz von Genitalwarzen lag für die Geburtskohorte 1989 bei 1,30 % (95 % KI: 1,12-1,49), während in jüngeren Geburtskohorten die Prävalenz niedriger war (0,94, 95 % KI: 0,79-1,10, Geburtskohorte 1992; [60]).…”

Section: Einfluss Der Hpv-impfung Auf Krebsvorstufen Und Genitalwarzenunclassified

HPV-Impfung zur Prävention von Genitalwarzen und Krebsvorstufen – Evidenzlage und Bewertung

Osmani

Klug

2021

Bundesgesundheitsbl

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ZusammenfassungHumane Papillomviren (HPV) verursachen benigne und maligne Tumorerkrankungen. Bisher wurden mehr als 200 HPV-Typen entdeckt, von denen aktuell 12 als Hochrisiko für das Zervixkarzinom klassifiziert werden. HPV-Typen, die den Anogenitaltrakt befallen, werden sexuell übertragen. Seit 2006 sind prophylaktische HPV-Impfstoffe erhältlich. Die Impfung soll vor dem ersten sexuellen Kontakt erfolgen.HPV infizieren Epithelzellen und sind die häufigsten sexuell übertragenen Viren weltweit. Neben dem Zervixkarzinom verursachen HPV auch andere anogenitale Tumore, wie Vulva‑, Vagina- und Analkarzinom, aber auch Oropharynxkarzinome. Vor allem die Hochrisiko-HPV-Typen 16 und 18 werden hier gefunden. Des Weiteren sind die HPV-Typen 6 und 11 ursächlich für die Entstehung von genitalen Warzen. Aber auch harmlose Hautwarzen werden von HPV verursacht.HPV-Impfstoffe sind sicher und hochwirksam, wenn vor der Impfung noch keine HPV-Infektion vorliegt. Systematische Reviews und Metaanalysen haben gezeigt, dass die HPV-Impfung eine HPV-Infektion, aber auch präkanzeröse Läsionen im Anogenitaltrakt und Genitalwarzen wirksam verhindert. Mittlerweile liegen erste direkte Hinweise vor, dass die HPV-Impfung die Inzidenz des Zervixkarzinoms reduziert.Die Impfquoten variieren weltweit je nach Impfprogramm und Akzeptanz des HPV-Impfstoffs in der Bevölkerung. Deutschland hat im Vergleich zu anderen europäischen Ländern niedrige Impfquoten. Die Ständige Impfkommission (STIKO) empfiehlt die HPV-Impfung in Deutschland für alle Mädchen und Jungen im Alter von 9 bis 14 Jahren. Im Jahr 2018 waren nur die Hälfte aller 18-jährigen Mädchen in Deutschland vollständig gegen HPV geimpft.Organisierte Impfprogramme, bevölkerungsbezogen oder schulbasiert, sind notwendig, um hohe Impfquoten zu erreichen.

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Section: Einfluss Der Hpv-impfung Auf Krebsvorstufen Und Genitalwarzenunclassified

HPV-Impfung zur Prävention von Genitalwarzen und Krebsvorstufen – Evidenzlage und Bewertung

Osmani

Klug

2021

Bundesgesundheitsbl

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“…In a recent study we demonstrated a substantial burden of HPV-associated anogenital diseases in 23–25-year-old women in Germany between 2012–2017 based on statutory health insurance (SHI) claims data [ 5 ]. The identified women were of special interest as these 23–25-year-olds were from the first birth cohorts eligible for HPV vaccination as adolescents after its introduction in Germany (birth cohorts 1989–1992) and because their identification enabled exploration of the burden of HPV-associated anogenital diseases in these young, less well studied age groups.…”

Section: Introductionmentioning

confidence: 99%

“…The identified women were of special interest as these 23–25-year-olds were from the first birth cohorts eligible for HPV vaccination as adolescents after its introduction in Germany (birth cohorts 1989–1992) and because their identification enabled exploration of the burden of HPV-associated anogenital diseases in these young, less well studied age groups. The most frequent diagnoses were anogenital warts with 3-year administrative prevalence rates for each birth cohort of 0.82–1.30% and grade 1 and grade 3 cervical intraepithelial neoplasia (CIN), with 3-year administrative prevalence rates of 1.31–1.60% for grade 1 lesions and 0.71–1.09% for grade 3 lesions [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…As healthcare resource utilization for anogenital diseases and associated costs have been quantified incompletely, the actual healthcare expenditures for the German statutory health insurance (SHI) are mostly unknown, especially concerning young women. This study addresses this gap in the literature using the 23–25-year-old women born between 1989–1992 identified in our prior study of HPV-associated anogenital disease burden [ 5 ]. This follow-up study assesses the healthcare resource utilization and costs for the Germany SHI of these women over a 3-year period.…”

Section: Introductionmentioning

confidence: 99%

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Healthcare resource utilization and costs in 23–25-year-old women with human papillomavirus (HPV) associated anogenital diseases in Germany – a retrospective analysis of statutory health insurance claims data

Reuschenbach

Mihm

Wölle

et al. 2022

BMC Health Serv Res

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Background Human papilloma virus (HPV) causes multiple anogenital diseases including cervical cancer and is the most common sexually transmitted infection. Healthcare resource utilization (HRU) associated with HPV-related anogenital diseases includes diagnostic and disease specific treatment regimens. A recent study showed disease burden of young women aged 23–25 years, who were the first populations eligible to receive HPV vaccination after its introduction in Germany. Cost for the German statutory health insurance (SHI) due to HPV‑related anogenital diseases in this population are unknown. This study aimed at assessing HRU and costs related to HPV-associated anogenital diseases for the Germany SHI. Methods We used a retrospective, matched cohort design to leverage the prior identified cohort of 23–25-year-old women born between 1989–1992 diagnosed with HPV-related anogenital disease from the Institute for Applied Health Research Berlin (InGef) Research Database. German SHI claims data from 2012–2017 were analyzed. The prior identified cases were matched (direct, without replacement) to women without anogenital diseases (1:10 ratio). HRU and costs for inpatient care, outpatient care, and pharmaceutical during a 3-year observation period were determined for both cases and controls and increments between the groups were assessed. Results 2,972 women diagnosed with anogenital diseases (cases) who were matched to 29,720 women without anogenital diseases (controls). Cases had more outpatient visits (52.4 visits vs. 39.2 visits) and more cases (45.2% vs. 31.7%) were hospitalized at least once in the 3‑year observation period. Most common outpatient procedures performed in cases were conization of the cervix uteri (4.4% cases; n < 5 controls), followed by other excision and destruction of diseased tissue of the cervix uteri (3.1% in cases; 0.0% in controls). Median difference in total healthcare costs of €684 (mean difference: €1,089, 95%CI: €752–1,426) suggest that HPV-related anogenital diseases were responsible for approximately €3.2 Million more healthcare costs for the identified cases in the four birth cohorts within the 3‑year observation period in the InGef Research Database. Costs were mainly driven by outpatient care (41.6% of total costs). Conclusion In Germany, HPV-related anogenital diseases among young women are associated with considerable HRU and financial expenditures, mostly driven by outpatient care.

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“… 13 , 14 , 15 However, over the last two decades, its incidence has increased, particularly among young women, and this is attributed to infection with HPV. 16 , 17 , 18 , 19 …”

Section: Introductionmentioning

confidence: 99%

High-risk human papillomavirus-associated vulvar neoplasia among women living with human immunodeficiency virus in Zambia

Maate

Julius

Siyumbwa

et al. 2022

African Journal of Laboratory Medicine

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Background: Globally, women living with HIV have a higher risk of vulvar neoplasia than HIV-negative women. Vulvar neoplasia among women living with HIV has not previously been characterised in Zambia.Objective: This study determined the clinical and pathologic features of vulvar neoplasia among women living with HIV at the University Teaching Hospital, Lusaka, Zambia.Methods: We conducted a cross-sectional study of vulvar lesions among 53 women living with HIV who presented with vulvar lesions between July 2017 and February 2018. The study assessed clinical and histological characteristics and prevalence of high-risk human papillomavirus (HRHPV).Results: Twenty-one patients were diagnosed with vulvar squamous cell carcinoma (VSCC), 20 with usual vulvar intraepithelial neoplasm (uVIN), and the rest with either benign lesions or non-neoplastic lesions (NNL). Participants’ mean age was 40 years. Patients with VSCC were significantly older than those with NNL (mean (s.d.): 43 (21) vs 33 (10), p = 0.004). The prevalence of HRHPV was 88.9% in VSCC patients and 100.0% in high-grade squamous intraepithelial lesion patients. HPV16 was the most common (52.6%) genotype. The clinical features of neoplasia were similar to those of NNL.Conclusion: VSCC was significantly more common among women aged ≥ 40 years. HRHPV in VSCC and high-grade squamous intraepithelial lesions was high. Women with vulvar lesions, especially those aged 40 years, should be evaluated for vulvar cancer. Young girls should be vaccinated to prevent vulvar cancer.

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Burden of HPV related anogenital diseases in young women in Germany – an analysis of German statutory health insurance claims data from 2012 to 2017

Cited by 12 publications

References 21 publications

HPV-Impfung zur Prävention von Genitalwarzen und Krebsvorstufen – Evidenzlage und Bewertung

HPV-Impfung zur Prävention von Genitalwarzen und Krebsvorstufen – Evidenzlage und Bewertung

Healthcare resource utilization and costs in 23–25-year-old women with human papillomavirus (HPV) associated anogenital diseases in Germany – a retrospective analysis of statutory health insurance claims data

High-risk human papillomavirus-associated vulvar neoplasia among women living with human immunodeficiency virus in Zambia

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