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Global burden of human papillomavirus and Related Diseases.

机译：人类乳头瘤病毒和相关疾病的全球负担。

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The worldwide prevalence of infection with human papillomavirus (HPV) in women without cervical abnormalities is 11-12% with higher rates in sub-Saharan Africa (24%), Eastern Europe (21%) and Latin America (16%). The two most prevalent types are HPV16 (3.2%) and HPV18 (1.4%). Prevalence increases in women with cervical pathology in proportion to the severity of the lesion reaching around 90% in women with grade 3 cervical intraepithelial neoplasia and invasive cancer. HPV infection has been identified as a definite human carcinogen for six types of cancer: cervix, penis, vulva, vagina, anus and oropharynx (including the base of the tongue and tonsils). Estimates of the incidence of these cancers for 2008 due to HPV infection have been calculated globally. Of the estimated 12.7 million cancers occurring in 2008, 610,000 (Population Attributable Fraction [PAF]=4.8%) could be attributed to HPV infection. The PAF varies substantially by geographic region and level of development, increasing to 6.9% in less developed regions of the world, 14.2% in sub-Saharan Africa and 15.5% in India, compared with 2.1% in more developed regions, 1.6% in Northern America and 1.2% in Australia/New Zealand. Cervical cancer, for which the PAF is estimated to be 100%, accounted for 530,000 (86.9%) of the HPV attributable cases with the other five cancer types accounting for the residual 80,000 cancers. Cervical cancer is the third most common female malignancy and shows a strong association with level of development, rates being at least four-fold higher in countries defined within the low ranking of the Human Development Index (HDI) compared with those in the very high category. Similar disparities are evident for 5-year survival-less than 20% in low HDI countries and more than 65% in very high countries. There are five-fold or greater differences in incidence between world regions. In those countries for which reliable temporal data are available, incidence rates appear to be consistently declining by approximately 2% per annum. There is, however, a lack of information from low HDI countries where screening is less likely to have been successfully implemented. Estimates of the projected incidence of cervical cancer in 2030, based solely on demographic factors, indicate a 2% increase in the global burden of cervical cancer, i.e., in balance with the current rate of decline. Due to the relative small numbers involved, it is difficult to discern temporal trends for the other cancers associated with HPV infection. Genital warts represent a sexually transmitted benign condition caused by HPV infection, especially HPV6 and HPV11. Reliable surveillance figures are difficult to obtain but data from developed countries indicate an annual incidence of 0.1 to 0.2% with a peak occurring at teenage and young adult ages.
机译：在全世界无宫颈异常的妇女中，人类乳头瘤病毒（HPV）感染的流行率为11-12％，其中撒哈拉以南非洲（24％），东欧（21％）和拉丁美洲（16％）的感染率更高。两种最普遍的类型是HPV16（3.2％）和HPV18（1.4％）。宫颈病变女性的患病率与病变的严重程度成比例，在患有3级宫颈上皮内瘤变和浸润性癌症的女性中，患病率达到约90％。 HPV感染已被确定为六种类型癌症的明确人类致癌物：宫颈癌，阴茎癌，外阴癌，阴道癌，肛门癌和口咽癌（包括舌根和扁桃体）。全球已对因HPV感染导致的2008年这些癌症的发病率进行了估算。在2008年估计发生的1,270万癌症中，有610,000（人口归因分数[PAF] = 4.8％）可归因于HPV感染。 PAF随地理区域和发展水平的不同而有很大差异，在世界欠发达地区增加到6.9％，在撒哈拉以南非洲地区增加到14.2％，在印度增加到15.5％，而较发达地区增加到2.1％，北部增加1.6％美国和澳大利亚/新西兰的1.2％。 PAF估计为100％的子宫颈癌占HPV归因病例的530,000（86.9％），其余五种癌症占剩余的80,000癌症。宫颈癌是第三大最常见的女性恶性肿瘤，与发展水平密切相关。在人类发展指数（HDI）排名较低的国家中，宫颈癌的发病率至少是非常高的国家的四倍。 。低人类发展指数国家的5年生存率也存在相似的差距，不到20％，在非常高的国家则超过65％。世界地区之间的发病率相差五倍甚至更大。在可获得可靠时间数据的国家中，发病率似乎每年持续下降约2％。但是，缺乏低人类发展指数国家的信息不足，在这些国家，成功进行筛查的可能性较小。仅根据人口统计因素对2030年子宫颈癌的预计发病率进行的估算表明，子宫颈癌的全球负担增加了2％，即与当前的下降速度保持平衡。由于涉及的数目相对较少，因此难以辨别与HPV感染相关的其他癌症的时间趋势。生殖器疣代表由HPV感染（尤其是HPV6和HPV11）引起的性传播良性疾病。难以获得可靠的监测数字，但发达国家的数据表明，年发病率为0.1％至0.2％，在青少年时期和青年时期达到峰值。

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