April 17, 2001 -- Widespread, routine screening of all sexually active women aged 25 or younger for chlamydia is needed to help stave off the severe health consequences of this silent sexuallly transmitted disease, a panel of experts recommends.
Chlamydia, a bacterial sexually transmitted disease (STD), often has no symptoms, so most people who are infected are not aware of it and, therefore, may not seek treatment. When diagnosed, chlamydia can be easily treated and cured with a course of antibiotics. Untreated, it can cause severe reproductive and other health problems, including pelvic inflammatory disease (PID), which is an important cause of infertility, potentially fatal tubal pregnancy, and increased risk of HIV, the AIDS virus.
An estimated three million cases of chlamydia occur annually and research suggests that most women are not being screened. This is why the U.S. Preventive Services Task Force is now recommending that screening for chlamydia become part of regular healthcare visits.
The group of independent experts is convened by the government's Agency for Healthcare Research and Quality to evaluate scientific data on many conditions and make recommendations regarding prevention and screening. The last report by this group was released in 1996.
"We need to raise both provider's and women's consciousness about this silent disease with severe health consequences," says Jane Allan, PhD, RN, the vice chair of the task force and the dean and professor in the school of nursing at the University of Texas Health Science Center in San Antonio, Texas.
According to the new chlamydia recommendations, any woman who is 25 or younger, sexually active, has multiple partners, or uses condoms inconsistently should be screened for chlamydia.
"If you meet the risk criteria, you may have this silent disease that is 100% curable with one-dose of an antibiotic," she says. "If it's [the test] not offered, then ask because the consequences are high. Any woman, even those older than 30, who meet the other criteria should be screened," she tells WebMD.
Chlamydia screening can be done with a urine test, she says. "In states where there is widespread screening, the incidence has gone way down," Allan adds.
The task force also broadened their recommendations regarding screening for high blood cholesterol levels, stating that cholesterol screening should not have an upper age limit. Current guidelines stop cholesterol screening at 65.
"The quality of data to support screening for high cholesterol in older people has improved," says task force chairman, Alfred O. Berg, MD, MPH, the chair of the department of family medicine at University of Washington in Seattle.
"Practically speaking, the recommendation may not make a big difference because most people have already been screened more than once by the time they turn 65," he says. "But there may be a small group of individuals who for whatever reason have never been screened before and now we have information that says screen them."
The new cholesterol guidelines also call for screening young adults beginning at age 20 if they are at risk for heart disease. Diabetes, high blood pressure, family history of heart disease, and tobacco use increase heart disease risk.
In a written statement, U.S. Secretary of Health and Human Services Tommy Thompson says, "So many of our health problems can be avoided through healthy lifestyles and preventive healthcare. These screening recommendations are an important step in our efforts to improve the quality of healthcare and quality of life for all Americans."
In addition, the new recommendations state that there is still insufficient scientific evidence to determine whether regular total body skin examination for skin cancer reduces illness and death. The task force reached this same conclusion in the 1996.
Also, despite research showing that pregnant women with bacterial vaginosis, a vaginal discharge caused by an imbalance in vaginal bacteria common among women of childbearing age, have a higher risk of preterm delivery, there is not enough evidence to merit regular screening.