Not Enough Young Women Get Tested for Chlamydia

Screening is important because chlamydia infections often produce no signs or symptoms and can have serious complications if left untreated. The test for this disease is relatively simple to perform and when infections are detected, they are easily treated with antimicrobials. Screening asymptomatic women can also help identify infected partners who need treatment since men are typically not tested until they develop symptoms. Detecting and treating chlamydia early can help limit spread of the disease.

Screening Rate is Too Low
The April 17 issue of Morbidity and Mortality Weekly Report presented the CDC’s analysis of seven years of data, from 2000 to 2007. The CDC examined data for 2.8 million sexually active females, collected by the National Committee for Quality Assurance from hundreds of commercial and Medicaid health plans. Although a Pap test and chlamydia screening can be done as part of the same exam, more than 70% of the women in the study got a Pap test in 2007, while far fewer had a test for chlamydia.

The national screening rate for chlamydia among young, sexually active females (ages 16 to 25) increased from 25% in 2000 to 43.6% in 2006: that’s the good news. In 2007, however, the screening rate was a disappointing 41.6%. Half of those with Medicaid were screened and only 39.6% in commercial health plans. 2007 was the first year since 2000 that the percentage of young women screened went down. A screening rate of around 40% is far too low for a common infection that can have serious consequences.

Facts about chlamydia infections

• Chlamydia is the most common bacterial STD in the United States. An estimated 3 million new cases occur here annually, and many cases go undetected.
• Teen girls and young women who have been sexually active have the highest rates of infection. In 2007, more than 1 million cases in US females were reported to the CDC, more than half in females 15 to 25 years old.
• Untreated chlamydia can have severe consequences. This sexually transmitted infection can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, and chronic pelvic pain. In the early stages, women tend to have only vague symptoms or no symptoms at all. The infection can be cured with oral antibiotics in a week. (The chlamydia test article has more information.)
• In pregnant women, chlamydia has been linked to an increased risk of miscarriage, stillbirth, and low birth weight.
• Infants exposed to chlamydia at birth are at risk for developing blindness and pneumonia.

Key Health Message
Chlamydia is easy and inexpensive to detect and cure. Those who are at risk should be tested at least once a year. (See the screening articles for more on specific recommendations, such as for young adults.) As with a Pap test, a gynecologist or other women’s health care provider can swab the cervix during a yearly pelvic exam to obtain a sample. Even simpler, during any office visit a urine sample can be collected privately by the patient.

Sources

CDC report: Chlamydia screening rates remain low (press release). 2009 Apr 17. Research Triangle Park, NC: American Social Health Association. Available online at http://www.ashastd.org/news/news_pressreleases_chlamydiascreening.cfm through http://www.ashastd.org. Accessed 25 Apr 2009.

Chlamydia (fast facts). Research Triangle Park, NC: American Social Health Association. Available online at http://www.ashastd.org/learn/learn_chlamydia_facts.cfm through http://www.ashastd.org. Accessed 25 Apr 2009.

US Centers for Disease Control and Prevention. 2009 Apr 17. Chlamydia screening among sexually active young female enrollees of health plans—United States, 2000—2007. MMWR 58(14);362-365.

US Preventive Services Task Force. 2007 Jun. Screening for Chlamydial infection: US Preventive Services Task Force recommendation. First published in Ann Intern Med 2007;147:128-33. Agency for Healthcare Research and Quality, Rockville, MD. Available online at http://www.ahrq.gov/clinic/uspstf07/chlamydia/chlamydiars.htm through http://www.ahrq.gov. Accessed 26 Apr 2009.