{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T02:49:15Z","timestamp":1765075755217,"version":"3.46.0"},"reference-count":24,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,2,17]]},"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Trends in occurrence of anogenital warts (AGWs) can provide early evidence of human papillomavirus (HPV) vaccination programme impact on preventing HPV infection and HPV-induced lesions. The objective of this study was to provide a baseline of AGW epidemiology in Ontario prior to the introduction of the publicly-funded school-based HPV vaccination programme in September 2007.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>As a retrospective longitudinal population-based study, we used health administrative data as a proxy to estimate incident AGWs and total health service utilisation (HSU) for AGWs for all Ontario residents 15\u2005years and older with valid health cards between 1 April 2003 and 31 March 2007.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The outcome of interest was AGW healthcare utilisation identified using the International Classification of Diseases, 10th revision (ICD-10) diagnostic code for AGWs, as well as an algorithm for identifying AGW physician office visits in a database with a unique system of diagnostic and procedural codes. An AGW case was considered incident if preceded by 12\u2005months without HSU for AGWs. Time trends by age group and sex were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between fiscal years 2003 and 2006, we identified 123\u2005247 health service visits for AGWs by 51\u2005436 Ontario residents 15\u2005years and older. Incident AGWs peaked in females and males in the 21\u201323\u2005year age group, at 3.74 per 1000 and 2.81 per 1000, respectively. HSU for AGWs peaked in females and males within the 21\u201323\u2005year age group, at 9.34 per 1000 and 7.22 per 1000, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>To the best of our knowledge, this is the first population-based study of AGW incidence and HSU in Ontario. The sex and age distribution of individuals with incident and prevalent AGWs in Ontario was similar to that of other provinces before HPV vaccine programme implementation in Canada.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009914","type":"journal-article","created":{"date-parts":[[2016,3,10]],"date-time":"2016-03-10T22:33:55Z","timestamp":1457649235000},"page":"e009914","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Health service utilisation for anogenital warts in Ontario, Canada prior to the human papillomavirus (HPV) vaccine programme introduction: a retrospective longitudinal population-based study"],"prefix":"10.1136","volume":"6","author":[{"given":"Fiona M","family":"Guerra","sequence":"first","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura C","family":"Rosella","sequence":"additional","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila","family":"Dunn","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of Toronto, Ontario, Canada"},{"name":"Women's College Hospital and Women's College Research Institute, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E","family":"Wilson","sequence":"additional","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Chen","sequence":"additional","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelley L","family":"Deeks","sequence":"additional","affiliation":[{"name":"Public Health Ontario, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,3,10]]},"reference":[{"key":"2025120618110797000_6.3.e009914.1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf180"},{"key":"2025120618110797000_6.3.e009914.2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit066"},{"key":"2025120618110797000_6.3.e009914.3","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1159\/000358370","article-title":"The epidemiology of human 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Supply and utilization of general practitioner and family physician services in Ontario. Institute for Clinical Evaluative Sciences. Toronto, ON: Institute for Clinical Evaluative Sciences, 2005. http:\/\/www.ices.on.ca\/Publications\/Atlases-and-Reports\/2005\/Supply-and-utilization (accessed Jul 2015)."},{"key":"2025120618110797000_6.3.e009914.20","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-2961"},{"key":"2025120618110797000_6.3.e009914.21","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1097\/OLQ.0b013e3182953ce0","article-title":"Incidence of Genital Warts in Adolescents and Young Adults in an Integrated Health Care Delivery System in the United States Before Human Papillomavirus Vaccine Recommendations","volume":"40","author":"Camenga","year":"2013","journal-title":"Sexually Transm Dis"},{"key":"2025120618110797000_6.3.e009914.22","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3182756efd"},{"key":"2025120618110797000_6.3.e009914.23","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S0020-2452(97)81370-X","article-title":"Epidemiology of genital human papillomavirus infections","volume":"95","author":"Xi","year":"1997","journal-title":"Bulletin de l'Institut Pasteur"},{"key":"2025120618110797000_6.3.e009914.24","doi-asserted-by":"publisher","DOI":"10.2307\/2991551"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2015-009914","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T02:11:15Z","timestamp":1765073475000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2015-009914"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2016,3,10]]},"published-print":{"date-parts":[[2016,3]]}},"alternative-id":["10.1136\/bmjopen-2015-009914"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2015-009914","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2016,3]]}}}