Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 225, Issue 1, Pages 94-104Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiab334
Keywords
human papillomavirus; cohort effect; natural history; epidemiology; sexually transmitted infection
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Funding
- Centers for Disease Control and Prevention
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The prevalence of any HPV, high-risk HPV, and non-high-risk HPV decreases with age in a cohort of women born between 1950 and 1979, indicating that the decline in HPV prevalence cannot be solely attributed to birth cohort differences.
Background. Apparent associations between human papillomavirus (HPV) prevalence and age observed in cross-sectional studies could be misleading if cohort effects influence HPV detection. Methods. Using data from 2003-2016 National Health and Nutrition Examination Surveys, we evaluated overall and 10-year birth cohort-specific cervicovaginal HPV prevalence estimates (any, high-risk [HR], and non-HR) by 3-year age group among 27 to 59-year-old women born in 1950-1979. Average percent changes (APC) in HPV prevalence by 3-year age were calculated. Results. Overall, prevalence of any HPV declined from 49.9% in 27-29 year olds to 33.8% in 57-59 year olds (APC, -2.82% per 3-year age group; 95% confidence interval [CI], -4.02% to -1.60%) as did prevalence of HR-HPV (APC, -6.19%; 95% CI, -8.09% to -4.26%) and non-HR-HPV (APC, -2.00%; 95% CI, -3.48% to -.51%). By birth cohort, declines by age group were seen in prevalences of any HPV, HR-HPV, and non-HR-HPV for those born in the 1950s and 1970s and in any HPV and HR-HPV for those born in the 1960s (APC range, -14.08% to 0.06%). Conclusions. Declines in HPV prevalence with age in these cross-sectional surveys cannot be explained by birth cohort differences alone, as associations were observed across all birth cohorts.
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