Government recommends increased screening for STDs

By Alex Kingsbury
U-WIRE Washington Bureau
May 7, 2001

A report released last month by the U.S. Preventive Services Task Force recommended all sexually active women ages 25 and younger be screened, by their primary care physicians, for the sexually transmitted disease chlamydia.

Citing the diseases’ rampant growth in the United States as well as the potential damage to women’s reproductive capabilities, the report recommended that primary care clinicians screen younger as well as older women at risk for chlamydia, as part of regular health care visits.

According to the Centers for Disease Control and the Task Force, the disease is the most common bacterial STD in the U.S., with more than three million new cases every year. Though the disease is easily and effectively treatable with antibiotics, 75 percent of women and 50 percent of men have no symptoms of infection.

The report’s recommendation is important because recent studies show that few at-risk women are being screened. According to a Journal of Adolescent Health survey of 546 doctors this spring, only 32 percent said they would screen an asymptomatic, sexually active teenage girl for chlamydia as part of a routine gynecologic examination. In addition, a 1997 study of four major U.S. HMOs indicated that only 2 percent to 42 percent of sexually active females aged 15 to 25 years had been screened for chlamydia.

In light of these numbers and further investigation, the Task Force concluded, “there is good scientific evidence that routine screening and treatment could reduce serious consequences of chlamydia in women.”

If left untreated, the CDC warns, chlamydia can lead to “severe, costly reproductive and other health problems … including pelvic inflammatory disease (PID), which is the critical link to infertility, and potentially fatal “tubal” pregnancy.”

“These new recommendations underscore the importance of prevention in primary care and further the scientific foundation for improved preventive care around the world,” said John M. Eisenberg, M.D., director of the Agency for Healthcare Research and Quality, which sponsors the Task Force.

Of women who remain untreated for the disease, 40 percent develop PID, and of those, 47 percent will become either infertile, have debilitating pelvic pain, or have a life-threatening tubal pregnancy. Also, women who have chlamydia are three to five times more likely to contract HIV if they are exposed.

“So many of our health problems can be avoided through healthy lifestyles and preventive health care,” said Health and Human Services Secretary Tommy G. Thompson. “These screening recommendations are an important step in our efforts to improve the quality of health care and quality of life for all Americans.”

Testing for chlamydia is a routine test preformed when blood work is done, according to health care providers.

Jenn King, spokeswoman for Aetna Healthcare, the nation’s largest HMO, said that the company fully covers such testing in routine examinations.

Though chlamydia also is common in young men, they are infrequently offered screening and the physical ramifications are less damaging. Infected men may experience urinary infections and swollen testicles.

Surveys conducted by the CDC in 1997 showed that instances of chlamydia differ by state, ranging from 4 to 14 percent. Results show higher instances in the Midwest and South, however; overall results are misleading due to the fact that these areas may test more often for the disease.

First convened by the U.S. Public Health Service in 1984, the U.S. Preventive Services Task Force is a group of private sector experts that offer evaluations of current services, create risk-recommendations for services based on gender and age that should be incorporated into primary medical care and work to plan research agendas in the field of preventive medical care.

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