the RRP Task Force Objective: To characterize the spectrum of juvenileonset recurrent respiratory papillomatosis (RRP) in the United States and to obtain data about the natural course of the disease and its response to treatment. Setting: Twenty tertiary-care pediatric otolaryngology centers throughout the United States. Patients: All patients with active RRP aged less than 18 years at the participating sites. Main Outcome Measures: Number of surgical procedures performed per year, progression

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... f papillomas to previously nondiseased anatomical sites, drug interventions and other adjuvant therapy, and need for tracheostomy. Results: Data were collected from 399 children enrolled from January 1, 1997, through December 31, 1998. There were 51.9% male; 62.7% white, 28.3% black, 9.0% other or unknown racial group; 10.8% Hispanic ethnicity. Mean age at diagnosis was 3.8 years (range, 0.1-16.3 years) and mean duration of disease was 4.4 years (range, 0.03-18.9 years). The mean number of surgical procedures per child was 4.4 per year (range, 0.2-19.3 per year). Children whose RRP was diagnosed at younger ages (Ͻ3.0 years) were 3.6 times more likely to have more than 4 surgical procedures per year (P = .001) and almost 2 times more likely to have 2 or more anatomical sites affected (P = .008) than were children whose RRP was diagnosed at later ages (Ն3.0 years), after adjusting for sex, race, and years of treatment. Conclusions: Children whose disease was diagnosed before age 3 years were more likely than children aged 3 years or older to have more severe disease as measured by the mean number of surgical procedures performed and by the number of anatomical sites affected. The registry will form the basis for future analysis on the outcome of disease, natural course of RRP under management strategies, prevention strategies, and public health importance.