Systematic Review of the Incidence and Prevalence of Genital Warts

Harshila Patel; Monika Wagner; Puneet Singhal; Smita Kothari


BMC Infect Dis. 2013;13(39) 

In This Article


Literature Searches

The PubMed and EMBASE databases were searched for articles published from January 2001 through January 2012 in English, French, German, Spanish or Italian using the following search terms: (genital warts OR genital wart OR anogenital warts OR anogenital wart OR condyloma* OR genital verruca*) AND (prevalence OR incidence OR epidemiolog*). Database searches were followed by manual searches of bibliographies of selected references. Available abstracts of the following relevant sexual health and infectious disease conferences from 2009 to 2011 were also searched: International Society for Sexually Transmitted Diseases Research (2009–2011), International Papillomavirus Conference (2009–2011), Infectious Diseases Society of America (2010, 2011), European Research Organization of Genital Infection and Neoplasia (2009–2011), Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (2009–2011), and International Conference on Emerging Infectious Diseases (2010, 2011).

Only original studies reporting AGW incidence, prevalence or self-reported history in the general adult (at least including ages 20 through 40 years) male, female or combined populations were selected. Studies focusing exclusively on children (age < 15 years) or adults within a narrow age range, those with study populations composed of immunocompromised individuals (e.g., HIV-infected) only, high-risk populations (e.g., men who have sex with men, sex workers), single-center studies (not reporting on epidemiology in the general population), case reports, commentaries, narratives or reviews were excluded.

Data Extraction and Analysis

Data extracted from all articles included the year of study, country (and sub-region, if relevant), setting, population, age groups, methodology, annual incidence (categorized into new, recurrent, and any cases, if available) overall and by age subgroup, prevalence (%) overall and by age subgroup, self-reported history of AGWs (within the past 12 months or lifetime) and temporal trends in the incidence of AGWs for males, females and overall. Reported incidence rates were recalculated per 100,000 population, if originally not reported as such. AGWs reported as 'new' or 'incident' were both termed 'new' in this review. For incidence and prevalence data collection, the methods consisted of extracting data from articles that included: (1) retrospective administrative databases or medical chart reviews, (2) prospectively collected physician reports, and (3) genital examinations performed by a healthcare provider on individuals from the general population visiting clinics. The age groups experiencing the highest incidence of AGWs and the incidence at that peak age were also recorded for each study, where available. Data across different sources were synthesized using descriptive statistics, including medians and ranges, where appropriate. For studies that only reported incidence for males and females separately, the average was taken to represent the overall incidence. The searches and data extraction were conducted by two investigators using the same methodology. In cases of disagreements, results were reconciled through mutual discussion.