Human papillomavirus (HPV) is a highly common sexually transmitted infection (STI). The US Centers for Disease Control and Prevention (CDC) reports that nearly all sexually active people contract HPV at some point. HPV infections are often asymptomatic, and the CDC notes that 90% of cases self-resolve within two years. However, HPV is also responsible for 5% of cancer cases worldwide. Of the 200 strains of sexually transmitted HPV, 12 have been identified as “high-risk” and are known to be oncogenic (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59). Cancers attributable to HPV include cervical cancer, anal cancer, penile cancer, and oropharyngeal cancer, among others.

In September 2023, Dr Laia Bruni and other researchers from the Catalan Institute of Oncology published a report on the global prevalence of HPV in men. Two factors contributing to this research were gaps in existing data and transmission by asymptomatic partners. Previous studies have focused on women and men at high risk of transmission, a group that includes men who have sex with men, HIV-positive men, men being treated for STIs, and partners of HPV-positive women. The study by Bruni and colleagues focuses on sexually active men who are not at high risk of HPV infection and aims to represent the general male population. The authors note that men serve as a reservoir for HPV, as they can be asymptomatic and still transmit the virus.

The researchers performed a metanalysis on publications found through Embase, Ovid MEDLINE, and Global Index Medicus. They required that included papers contain data on at least 50 men, that those men are aged 15 years and older, that the infection is asymptomatic, and that the diagnostic sample was taken from the genital area. The researchers excluded papers that focused exclusively on circumcised men, high-risk men, or HPV-vaccinated men, as well as papers where diagnosis was made using semen or urine. The final analysis included data on 44,769 men from 65 different studies, published from 1 January 1995 to 1 June 2022. High-risk (HR) HPV was defined in each individual publication, so the authors used study-defined HR-HPV for global HR-HPV prevalence.

The study reported the global prevalence of all HPV and HR-HPV. The global prevalence of all strains of HPV in men ages 15 years and older was 31%, with a 95% confidence interval (CI) of 27–35%. It is seen most often in men ages 25–29 years (35%, 95% CI 30–41%), followed by men ages 15–19 years (28%, 95% CI 24–32%). The global prevalence of HR-HPV was 21%, with a 95% confidence interval of 18–24%. HR-HPV age trends followed that of all HPV, with a prevalence of 24% in men ages 25–29 years (95% CI 19–29%) and a prevalence of 20% in men ages 15–19 years (95% CI 17–23%). Age trends after the age of 30 years vary by region. In Europe and Eastern and Southeastern Asia, prevalence remains steady, while prevalence declines slightly in Latin America and the Caribbean, and declines more dramatically in Sub-Saharan Africa. HPV prevalence only increases in Northern America, peaking at ages 30–39 years and then remaining steady. The authors posit that men are susceptible to infection upon their first sexual encounter and remain susceptible throughout their lifetime. This makes them a sustained reservoir for the virus.

Bruni and colleagues also reported prevalence rates by region. The two regions with the highest all-HPV prevalence were Sub-Saharan Africa at 37% prevalence, followed by Europe and Northern America (36%), Latin America and the Caribbean (30%), Oceania (28%), and Eastern and Southeastern Asia (15%). This same pattern is seen in HR-HPV prevalence. Sub-Saharan Africa reported 25% prevalence, followed by Europe and Northern America (24%), Latin America and the Caribbean (22%), Oceania (19%), and Eastern and Southeastern Asia (10%). This translates to potential transmission of oncogenic HPV from 10–25% of sexually active men older than age 15 years, all of whom are asymptomatic.

An April 2017 study from the International Agency for Research on Cancer reports that, as of 2012, HPV is attributed to 100% of cervical cancer cases, 88% of anal cancer cases, 50% of penile cancer cases, and 30.8% of oropharyngeal cancer cases worldwide. GlobalData epidemiologists forecast that, in 2023, in the 16 major markets (the US, France, Germany, Italy, Spain, the UK, Australia, Brazil, Canada, China, India, Japan, Mexico, Russia, South Africa, and South Korea), there will be 1,065,000 diagnosed prevalent cases of cervical cancer in adult (ages ≥18 years) women and 61,000 diagnosed prevalent cases of penile cancer in adult men. GlobalData also forecasts that there will be 34,000 diagnosed incident cases of anal cancer in adult men and women in the same timeframe and region that are specifically attributable to HPV. In the seven major markets (US, France, Germany, Italy, Spain, the UK, and Japan), GlobalData epidemiologists forecast that there will be 4,500 diagnosed incident cases of oropharyngeal cancer in HPV-positive adult men and women in 2023.

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Although there are guidelines in place for cervical cancer and HPV screening in women, the CDC reports that there is currently no approved testing or routine screening for HPV in men. Preventative measures against HPV consist of vaccination and condom use. The CDC recommends vaccination against HPV for boys and girls aged 11 or 12 years, as well as anyone up to age 26 years, if not already vaccinated.