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RESEARCH ARTICLE

Estimating the burden of genital warts in Taiwan

Tsen-Fang Tsai A G , Smita Kothari-Talwar B , Karen Yee C , Amit Kulkarni B , Nuria Lara D , Montserrat Roset D , Anna R. Giuliano E and Suzanne M. Garland F
+ Author Affiliations
- Author Affiliations

A National Taiwan University Hospital, No. 7, Zhongshan S Road, Zhongzheng District, Taipei City, 100, Taiwan.

B Merck & Co. Inc., 2000 Galloping Hill Road, Kenilworth, NJ 07033, USA.

C Cubist Pharmaceuticals, 65 Hayden Avenue, Lexington, MA 02421, USA.

D Intercontinental Marketing Services Health, Carrer de Provença, 392, 08025 Barcelona, Spain.

E Center for Infection Research in Cancer at Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.

F Royal Women’s Hospital, 20 Flemington Road, Parkville, Vic. 3052, Australia.

G Corresponding author. Email: tftsai@yahoo.com

Sexual Health - https://doi.org/10.1071/SH17013
Submitted: 24 January 2017  Accepted: 21 May 2017   Published online: 3 October 2017

Abstract

Background: This study aimed to estimate the prevalence of genital warts in Taiwan among those seeking healthcare, as well as genital-warts-related healthcare resource use and costs, and self-reported genital-warts-related psychosocial impact. Methods: Genital warts prevalence estimates were extracted from a daily record of patients examined from 31 October 2011 to 4 May 2012 by 67 physicians in Taiwan. Physicians recorded the total number of patients and genital warts patients seen daily for 2 weeks. These physicians also completed a survey regarding healthcare resource use, treatment, follow-up care, and referral patterns. Patient psychosocial impact was estimated using a self-administered survey. Results: The overall prevalence of genital warts in Taiwan was estimated at 1.1%, with a higher prevalence among men. A total of 146 genital warts case patients were included in the study (76 men, 70 women). Median costs for diagnosis and treatment were US$222 for male and US$351.8 for female patients. Male genital warts subjects reported a negative psychosocial impact on their well-being and health-related quality of life – psychosocial impact results are reported in the Supplementary Material file. Conclusions: Genital warts prevalence was higher among male patients; female patients incurred higher costs. Among men, genital warts had a negative psychosocial impact on well-being and health-related quality of life.

Additional keywords: cost-effectiveness, health services.


References

[1]  Arima Y, Winer RL, Feng Q, Hughes JP, Lee SK, Stern ME, O’Reilly SF, Koutsky LA. Development of genital warts after incident detection of human papillomavirus infection in young men. J Infect Dis 2010; 202 1181–4.
Development of genital warts after incident detection of human papillomavirus infection in young men.CrossRef |

[2]  Patel H, Wagner M, Singhal P, Kothari S. Systematic review of the incidence and prevalence of genital warts. BMC Infect Dis 2013; 13 39
Systematic review of the incidence and prevalence of genital warts.CrossRef |

[3]  Pirotta MV, Stein AN, Fairley CK, Morrow A, Conway EL, Chuah J, McCloskey J, McNulty A, Waddell R, Carter R, Garland S. Patterns of treatment of external genital warts in Australian sexual health clinics. Sex Transm Dis 2009; 36 375–9.
Patterns of treatment of external genital warts in Australian sexual health clinics.CrossRef |

[4]  Haupt RM, Sings HL. The efficacy and safety of the quadrivalent human papillomavirus 6/11/16/18 vaccine gardasil. J Adolesc Health 2011; 49 467–75.
The efficacy and safety of the quadrivalent human papillomavirus 6/11/16/18 vaccine gardasil.CrossRef |

[5]  Garland SM, Steben M, Sings HL, James M, Lu S, Railkar R, Barr E, Haupt RM, Joura EA. Natural history of genital warts: analysis of the placebo arm of 2 randomized phase III trials of a quadrivalent human papillomavirus (types 6, 11, 16, and 18) vaccine. J Infect Dis 2009; 199 805–14.
Natural history of genital warts: analysis of the placebo arm of 2 randomized phase III trials of a quadrivalent human papillomavirus (types 6, 11, 16, and 18) vaccine.CrossRef |

[6]  Raymakers AJ, Sadatsafavi M, Marra F, Marra CA. Economic and humanistic burden of external genital warts. Pharmacoeconomics 2012; 30 1–16.
Economic and humanistic burden of external genital warts.CrossRef |

[7]  de Sanjosé S, Diaz M, Castellsagué X, Clifford G, Bruni L, Muñoz N, Bosch FX. Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect Dis 2007; 7 453–9.
Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis.CrossRef |

[8]  Wang YY, Li L, Wei S, Peng J, Yuan SX, Xie JS, Liu ZH. Human papillomavirus (HPV) infection in women participating in cervical cancer screening from 2006 to 2010 in Shenzhen City, South China. Asian Pac J Cancer Prev 2013; 14 7483–7.
Human papillomavirus (HPV) infection in women participating in cervical cancer screening from 2006 to 2010 in Shenzhen City, South China.CrossRef |

[9]  Cheng YP, Chen CW, Sheen YS, Tsai TF. Genotype distribution of human papillomavirus in anogenital warts of male patients in Taiwan. Dermatologica Sinica 2012; 30 85–9.
Genotype distribution of human papillomavirus in anogenital warts of male patients in Taiwan.CrossRef |

[10]  Tsao YP, Yang KY, Han CP, Yin CS, Yang YF, Chen SL. Genital human papillomavirus infections in Taiwan. Int J Gynaecol Obstet 1994; 44 39–45.
Genital human papillomavirus infections in Taiwan.CrossRef | 1:STN:280:DyaK2c7msVCjtQ%3D%3D&md5=3b329aaa58b7fba9ccf5a83ac19f8f40CAS |

[11]  Liu PH, Hu FC, Lee PI, Chow SN, Huang CW, Wang JD. Cost-effectiveness of human papillomavirus vaccination for prevention of cervical cancer in Taiwan. BMC Health Serv Res 2010; 10 11
Cost-effectiveness of human papillomavirus vaccination for prevention of cervical cancer in Taiwan.CrossRef |

[12]  Pirotta M, Stein AN, Conway EL, Harrison C, Britt H, Garland S. Genital warts incidence and healthcare resource utilisation in Australia. Sex Transm Infect 2010; 86 181–6.
Genital warts incidence and healthcare resource utilisation in Australia.CrossRef |

[13]  Jeynes C, Chung MC, Challenor R. ‘Shame on you’ – the psychosocial impact of genital warts. Int J STD AIDS 2009; 20 557–60.
‘Shame on you’ – the psychosocial impact of genital warts.CrossRef | 1:STN:280:DC%2BD1Mrgt1ektw%3D%3D&md5=3e4af8ab924385ad55a5a438d1b29eefCAS |

[14]  Wang KL, Jeng CJ, Yang YC, Chen CA, Cheng WF, Chen TC, Mast TC, Wang YC, Hsieh CY. The psychological impact of illness among women experiencing human papillomavirus-related illness or screening interventions. J Psychosom Obstet Gynaecol 2010; 31 16–23.
The psychological impact of illness among women experiencing human papillomavirus-related illness or screening interventions.CrossRef | 1:CAS:528:DC%2BC3MXislKhu74%3D&md5=efe6caabd2f6bcab1c28bc3e68b50da2CAS |

[15]  Low JJ, Ko Y, Ilancheran A, Zhang XH, Singhal PK, Tay SK. Health and economic burden of HPV-related diseases in Singapore. Asian Pac J Cancer Prev 2012; 13 305–8.
Health and economic burden of HPV-related diseases in Singapore.CrossRef |

[16]  Ali H, Donovan B, Wand H, Read TR, Regan DG, Grulich AE, Fairley CK, Guy RJ. Genital warts in young Australians five years into national human papillomavirus vaccination programme: national surveillance data. BMJ 2013; 346 f2032
Genital warts in young Australians five years into national human papillomavirus vaccination programme: national surveillance data.CrossRef |

[17]  Harrison C, Britt H, Garland S, Conway L, Stein A, Pirotta M, Fairley C. Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study. PLoS One 2014; 9 e105967
Decreased management of genital warts in young women in Australian general practice post introduction of national HPV vaccination program: results from a nationally representative cross-sectional general practice study.CrossRef |

[18]  Mast TC, Zhu X, Demuro-Mercon C, Cummings HW, Sings HL, Ferris DG. Development and psychometric properties of the HPV Impact Profile (HIP) to assess the psychosocial burden of HPV. Curr Med Res Opin 2009; 25 2609–19.
Development and psychometric properties of the HPV Impact Profile (HIP) to assess the psychosocial burden of HPV.CrossRef |

[19]  National Health Insurance Administration Ministry of Health and Welfare (TW). 2017 National Health Insurance program and payment of medical services payment standard. Taipei: National Health Insurance Administration. Available online at: http://www.nhi.gov.tw/query/query2.aspx?menu=20&menu_id=710&webdata_id=3633&WD_ID=900 [verified 4 August 2015].

[20]  Lin C, Lau JT, Ho KM, Lau MC, Tsui HY, Lo KK. Incidence of genital warts among the Hong Kong general adult population. BMC Infect Dis 2010; 10 272
Incidence of genital warts among the Hong Kong general adult population.CrossRef |

[21]  Kjaer SK, Tran TN, Sparen P, Tryggvadottir L, Munk C, Dasbach E, Liaw K-L, Nygard J,, Nygard M. The burden of genital warts: a study of nearly 70,000 women from the general female population in the 4 Nordic countries. J Infect Dis 2007; 196 1447–54.
The burden of genital warts: a study of nearly 70,000 women from the general female population in the 4 Nordic countries.CrossRef |

[22]  Marra F, Ogilvie G, Colley L, Kliewer E, Marra CA. Epidemiology and costs associated with genital warts in Canada. Sex Transm Infect 2009; 85 111–5.
Epidemiology and costs associated with genital warts in Canada.CrossRef | 1:STN:280:DC%2BD1M3is1Crug%3D%3D&md5=93ecd9c4e2bd35823259ab812e7a68acCAS |

[23]  Castellsagué X, Cohet C, Puig-Tintoré LM, Acebes LO, Salinas J, San Martin M, Breitscheidel L, Remy V. Epidemiology and cost of treatment of genital warts in Spain. Eur J Public Health 2009; 19 106–10.
Epidemiology and cost of treatment of genital warts in Spain.CrossRef |

[24]  Mays RM, Zimet GD, Winston Y, Kee R, Dickes J, Su L. Human papillomavirus, genital warts, pap smears, and cervical cancer: knowledge and beliefs of adolescent and adult women. Health Care Women Int 2000; 21 361–74.
Human papillomavirus, genital warts, pap smears, and cervical cancer: knowledge and beliefs of adolescent and adult women.CrossRef | 1:STN:280:DC%2BD3M7mtVyiug%3D%3D&md5=be06d68fd6d36438ecad93d241546545CAS |

[25]  Manhart LE, Koutsky LA. Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia? A meta-analysis. Sex Transm Dis 2002; 29 725–35.
Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia? A meta-analysis.CrossRef |

[26]  Kucukunal A, Altunay IK, Mercan S. Sexual dysfunction in men suffering from genital warts. J Sex Med 2013; 10 1585–91.
Sexual dysfunction in men suffering from genital warts.CrossRef |

[27]  Lee CB, Choe HS, Hwang SJ, Lee SJ, Cho YH. Epidemiological characteristics of genital herpes and Condyloma acuminata in patients presenting to urologic and gynecologic clinics in Korea. J Infect Chemother 2011; 17 351–7.
Epidemiological characteristics of genital herpes and Condyloma acuminata in patients presenting to urologic and gynecologic clinics in Korea.CrossRef |

[28]  Hoy T, Singhal PK, Willey VJ, Insinga RP. Assessing incidence and economic burden of genital warts with data from a US commercially insured population. Curr Med Res Opin 2009; 25 2343–51.
Assessing incidence and economic burden of genital warts with data from a US commercially insured population.CrossRef |

[29]  Vilata JJ, Varela JA, Olmos L, Colombo JA, Llorens MA, de los Terreros MS, Badía X, ECCAVIM Study Group Validation and clinical use of the CECA, a disease-specific quality of life questionnaire for patients with anogenital condylomata acuminata. Acta Derm Venereol 2008; 88 257–62.

[30]  Desai S, Wetten S, Woodhall SC, Peters L, Hughes G, Soldan K. Genital warts and cost of care in England. Sex Transm Infect 2011; 87 464–8.
Genital warts and cost of care in England.CrossRef |

[31]  Dandona L, Sisodia P, Prasad TL, Marseille E, Chalapathi Rao M, Kumar AA, Kumar SGP, Ramesh YK, Over M, Someshwar M, Kahn JG. Cost and efficiency of public sector sexually transmitted infection clinics in Andhra Pradesh, India. BMC Health Serv Res 2005; 5 69
Cost and efficiency of public sector sexually transmitted infection clinics in Andhra Pradesh, India.CrossRef |

[32]  Dinh TH, Sternberg M, Dunne EF, Markowitz LE. Genital warts among 18- to 59-year-olds in the United States, national health and nutrition examination survey, 1999–2004. Sex Transm Dis 2008; 35 357–60.
Genital warts among 18- to 59-year-olds in the United States, national health and nutrition examination survey, 1999–2004.CrossRef |



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