In the past decade research has clearly demonstrated that HPV causes cancer in men and women at multiple anatomic sites. While the natural history of cervical HPV infections is well understood following decades of research globally on this one anatomic site, there have been far fewer studies examining the natural history of HPV at the anal canal and oral epithelium in men and women, penile epithelium in men, and vulvar and vaginal epithelia in women.
Often mirroring cancer incidence rates, HPV prevalence and infection natural history varies by gender and anatomic site of infection. Among men, penile HPV prevalence is high at ~50% with remarkable consistency across the countries reporting prevalence at this anatomic site. Penile or external genital HPV infections in men are consistently higher than observed among women of similar countries. Overall, anal HPV prevalence is relatively low at ~10% in the general male population but fold higher when examined among men who have sex with men (MSM). Oral HPV infection is rare (~5%) and significantly differs by gender whereby males have significantly higher prevalence compared to females.
More research is needed to characterize HPV natural history at each anatomic site where HPV causes cancer in men and women, information that is critical to inform the basic science of HPV natural history and to the development of future infection and cancer prevention efforts.