A new set of recommendations suggest that primary care physicians should screen all sexually active women 25 years or younger for chlamydia during their annual pelvic exam. Chlamydia is the most common sexually transmitted disease in the US, affecting an estimated 3 million women each year.
Currently, only a third of young women are routinely screened for chlamydia at their annual check-up. Based on better quality scientific evidence, the third US Preventive Services Task Force (USPSTF) has now concluded that routine screening for chlamydia in young women is needed.
“In addition to causing urinary infection, chlamydia can cause serious pelvic inflammatory disease, which can cause infertility and chronic pelvic pain,” says Alfred Berg, MD, MPH, chair of the USPSTF. “It can be without symptoms for a long time. That’s why it’s a good thing to be screened to prevent those long-term complications.”
Berg, who is also chair of the department of family medicine at the University of Washington in Seattle, points out that young women who have more than one sexual partner and who don’t use barrier contraceptives consistently should be screened. Although chlamydia is more common among younger women, Berg says that older women who have a new or multiple sexual partners, who have had a sexually transmitted disease in the past or who do not use condoms correctly and consistently should also be screened.
Chlamydia is treatable and curable with antibiotics, says Berg.
Barbara Yawn, MD, MSc, a family physician, and director of research at Olmsted Medical Center in Rochester, Minnesota, says that the recommendations will be very helpful in clinical practice considering that chlamydia screening has been controversial. “We’ve been back and forth with different research results by different groups on whether and when to screen women,” says Yawn. “But now, having someone review all the evidence and come up with straightforward recommendations really helps.”
Yawn says that in her own practice, she will continue to screen older women who are at high risk for chlamydia, but now she knows exactly who to screen. “Women who are less than 25 and are sexually active,” says Yawn. “This helps solidify what we do in practice. It’s going to be a lot easier.”
This time around, the USPSTF adopted a new approach in releasing new recommendations: “We decided to release new recommendations as they are developed rather than waiting for 5 years and producing a book as was done in the past,” says Berg, chair of the USPSTF.
Other recommendations in the report include:
* In addition to measure total cholesterol levels, high density lipoprotein should (HDL) also be measured annually.
* Cholesterol testing should include persons over the age of 65.
* Routine screening for skin cancer and a condition called bacterial vaginosis, an infection that has been linked to pre-term birth in some pregnant women, was not recommended.
The USPSTF consists of a panel of independent, private-sector experts in prevention and primary care. It conducts impartial assessments of scientific evidence for a broad range of clinical conditions to produce recommendations for the regular provision of clinical preventive services. These recommendations are available in the April issue of the American Journal of Preventive Medicine and some government Web sites.
Article By: Hong Mautz, Medical Writer