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HPV Prevalence in U.S. Women

Overall prevalence is higher than previously estimated, but types covered by the new vaccine are relatively uncommon.

The prevalence of human papillomavirus (HPV) among U.S. women is of particular interest, given the recent availability of an HPV vaccine. Government investigators used data from the 2003-2004 National Health and Nutrition Examination Survey to study HPV prevalence in women 14 to 59 years old. Self-collected vaginal swabs were analyzed by PCR; up to 37 HPV types were identified.

Among 1921 usable specimens, 27% were positive for HPV. The prevalence peaked at 45% in women 20 to 24 years old (34% for ages 14 to 24) and declined to 20% in women ages 50 to 59. For the four HPV types covered by the vaccine, prevalences were 1.3% for type 6, 0.1% for type 11, 1.5% for type 16, and 0.8% for type 18 (the latter two types are considered responsible for about 70% of cases of cervical cancer). HPV prevalence among women who reported never having had sex was 5%.

Comment: Although the overall prevalence of HPV in this study is higher than previously found, the prevalence of the types covered by the new vaccine (3.4% overall) is lower than expected. This lower prevalence may change current cost-effectiveness calculations for the new vaccine, but editorialists think it "unlikely that a reanalysis would change the conclusion that universal immunization is cost-effective." In any case, these data establish a baseline against which to measure the effect of the vaccine on future HPV prevalence.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine March 8, 2007

Citation(s):

Dunne EF et al. Prevalence of HPV infection among females in the United States. JAMA 2007 Feb 28; 297:813-9.

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• Medline abstract (Free)

Weller SC and Stanberry LR. Estimating the population prevalence of HPV. JAMA 2007 Feb 28; 297:876-8.

• Original article (Subscription may be required)
• Medline abstract (Free)