CDC: Chlamydia Testing Disappointingly Low

Most sexually active women not tested for the sexually transmitted disease

THURSDAY, Oct. 28, 2004 (HealthDayNews) -- The great majority of sexually active young American women enrolled in health plans are ignoring repeated recommendations that they get routine screening for chlamydia, the most commonly reported sexually transmitted disease, a new report says.

Only 26 percent of women enrolled in commercial health plans who were eligible for screening were tested in 2001, according to the report in the Oct. 29 issue of the Morbidity and Mortality Weekly Report, a publication of the U.S. Centers for Disease Control and Prevention. Only 38 percent of eligible women in Medicaid plans were screened, the report said.

"These are disappointing numbers," said Dr. Cathleen Walsh, a CDC senior health scientist. "There has been a change upward, but it is a very small change. Chlamydia screening has been recommended by the CDC and several clinical organizations for more than a decade, yet the numbers remain low. There is a striking disconnect between the recommendations and actual practice."

The fault lies with both gynecologists and women, said Dr. Kathleen Irwin, chief of the Health Services Research Division at the CDC's Sexually Transmitted Diseases Prevention branch.

"From the perspective of the provider, physicians might not be aware of sexual activity, particularly in younger patients," Irwin said. "They may be reluctant to be aware that there are chlamydia infections in these patients."

But the infections are too often there -- an estimated 3 million new cases every year, Irwin said.

One reason why infected women don't have a screening test is that chlamydia causes no symptoms in 70 percent of cases, she said. Another is that many women simply are not aware of the danger, since chlamydia was recognized as an important sexually transmitted disease only in the 1970s, Irwin said. The same is true of many physicians, she said.

A chlamydia infection is easily treated, often with a single dose of antibiotics. Detection is also easy, with a urine-sample test; results are generally available within a day. "You don't even have to have a pelvic examination," Walsh said.

Undetected and untreated, chlamydia can cause problems including pelvic inflammatory disease, infertility, and ectopic pregnancy. Routine screening has been recommended since the 1990s for all sexually active women 26 and younger and for all pregnant women.

The CDC has been working with organizations including the American College of Obstetrics and Gynecology and the American Academy of Pediatrics to get the message to both physicians and young women, Irwin said. The government has funded a national awareness program since 1994, and the chlamydia test has been made a medical benefit for all federal employees, she said.

"Doctor should definitely ask young women if they have been screened," Walsh said. "It is even more important that a sexually active woman ask for screening."

More information

Basic facts on the detection and treatment of chlamydia can be found at the U.S. Centers for Disease Control and Prevention.

SOURCES: Cathleen Walsh, Dr.P.H., senior health scientist, U.S. Centers for Disease Control and Prevention, Atlanta; Kathleen Irwin, M.D., chief, Health Services Research Division, Sexually Transmitted Diseases Prevention, U.S. Centers for Disease Control and Prevention, Atlanta; Oct. 29, 2004, Morbidity and Mortality Weekly Report
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