Epidemiologic, clinical, and economic burden of anogenital warts among adults: A global systematic review
Xuedan You, Stefano Valente, Dorothy A. Machalek, Marisa Felsher, Izabela Pieniążek, Kinga Nowicka, Joseph E. Tota, Ya-Ting Chen, Linda M. Niccolai, Fuqiang Cui
Abstract
OBJECTIVES: Anogenital warts (AGW) are a common manifestation of human papillomavirus (HPV) infection. As HPV vaccination programs expand, updated data are needed to assess the ongoing global AGW burden. This systematic review examined AGW epidemiology, clinical impact, and economic burden, analyzing 187 studies from 49 jurisdictions by income level, sex, and age. METHODS: Publications were retrieved from Embase, MEDLINE, and Evidence-Based Medicine Reviews (January 2013 to October 2023) and conference proceedings (January 2021 to December 2023) (PROSPERO ID: CRD42023489504). RESULTS AND CONCLUSIONS: AGW prevalence ranged from 0.5% to 33.1%, and incidence rates ranged from 24 to 2940 cases/100,000 person-years in mixed-sex populations not stratified by age. Incidence generally declined from the mid-30s but remained substantial across all ages. The clinical and economic burden varied by sex, age, time, and geography. Notably, most epidemiologic data come from high-income jurisdictions, underscoring the need for more comprehensive global surveillance to fully understand AGW trends and impacts.