What does this research mean for the field?

Unvaccinated US women aged 27 and older continue to acquire new HPV infections throughout their lifespan, with an overall 5-year cumulative incidence of 10.3% that varies by age and demographic factors. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to understand the incidence of human papillomavirus (HPV) infections in unvaccinated women aged 27 years and older in the US.

April 19, 2026Open Access

Incidence of human papillomavirus infections in women aged 27 years and older in the US: A federated data network study

Key Points

This study aims to understand the incidence of human papillomavirus (HPV) infections in unvaccinated women aged 27 years and older in the US.
Conducted as a retrospective cohort study using de-identified electronic health records.
Included unvaccinated women aged 27 years and older with a confirmed negative HPV test.
Analyzed data for cumulative incidence of HPV infection over five years, stratified by age and demographics.
Overall five-year cumulative incidence rate of HPV infection was 10.3%.
Higher incidences were noted in younger age groups and increased again after age 70.
Increased infection rates were observed among Black, Hispanic, and Medicaid-enrolled women.

Abstract

Background:The US Advisory Committee on Immunization Practices recommends shared clinical decision-making (SCDM) regarding human papillomavirus (HPV) vaccination for individuals aged 27-45 years.Incidence of HPV infection in this age group is not wellunderstood.This study assessed anogenital HPV infection incidence in a large cohort of unvaccinated US women aged 27 years and older.Methods: This retrospective cohort study included women aged 27 years and over, who had a documented visit, without prior record of HPV vaccination and a confirmed negative HPV test within the TriNetX Dataworks-USA network (Dataworks), a large, de-identified, federated network of electronic health records (EHRs), between January 1, 2012 and January 6, 2024.Cumulative incidence of HPV infection over five-year time period was calculated, overall and stratified by age and demographic characteristics.Analyses were also conducted in a subset of the population whose EHRs were linked to closed health insurance claims through tokenization (Linked). Findings:The overall five-year cumulative incidence rate in the Dataworks sample (n = 305,974) was 10.3% 10.2%, 10.5%.Cumulative incidence estimates were higher for the younger age groups, declined through age 59, and then increased through age 70+.Analyses in a subset of 9,772 women in the Linked sample showed similar patterns.Higher HPV infection incidence was observed among Black, Hispanic, and Medicaid-enrolled women.Interpretation: In a large cohort of US women ages 27 and older, new HPV infections were acquired throughout the lifespan.These women and their partners can benefit from preventive strategies to reduce risk of HPV-related diseases

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