The Cost-Effectiveness of Screening for Chlamydia in Women 15 to 29 Years of Age FREE

Sexually transmitted diseases are infections that spread from one person to another during sexual relations. Chlamydia trachomatis is a bacterium causing a common sexually transmitted infection (chlamydia) in the United States. Chlamydia can cause discharge from the vagina or penis, pain with urination, or abdominal pain. However, some people with chlamydia have no symptoms. Treatment with antibiotic drugs is important to get rid of symptoms, stop the spread of infection to others, and prevent complications of the infections. In women, chlamydia can cause difficulties in becoming pregnant (infertility). Infections in pregnant women can lead to premature birth and other problems in newborns.

Doctors can screen women for chlamydia by using either a swab of the cervix taken during a pelvic examination or urine samples. Until recently, the Centers for Disease Control and Prevention has recommended yearly screening for chlamydia in sexually active women younger than 25 years of age. Studies show that this strategy is cost-effective, which means that the benefits are worth the costs. However, because the Centers for Disease Control and Prevention noticed increases in repeated infection after treatment, it has changed its recommendation to include repeated testing after treatment for women who test positive. Also, since new studies show increases in infection in women older than 25 years of age, it has been suggested that screening continue up through 29 years of age. The cost-effectiveness of the new recommendations is unknown.

To find out whether the costs of the new chlamydia screening recommendations are worth the potential benefits.

Rather than studying actual patients, the researchers used computers to simulate what would happen to a “virtual” group of sexually active women 15 to 29 years of age.

The researchers used published information to estimate what might happen (and how much it would cost) if doctors followed each of the 4 following screening strategies: 1) no chlamydia screening, 2) yearly screening for sexually active women 15 to 29 years of age, 3) yearly screening followed by a repeated test within 6 months of any positive test result, and 4) screening every 6 months for women with previous infection.

Yearly chlamydia screening for women 15 to 29 years of age followed by screening every 6 months for those with a history of infection was the most effective and most cost-effective strategy.

The study was a computer simulation, so we cannot be sure what the results would be with actual patients.

Extending chlamydia screening to include women up through 29 years of age and to provide more frequent screening for women with previous infections seems to be a cost-effective use of resources in comparison to other well-accepted medical practices.