Change in Pap Test Rules May Be Linked to Drop in STD Screening

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Change in Pap Test Rules May Be Linked to Drop in STD Screening

Chlamydia screening plummets at one university’s health centers

Pap test guidelines were changed in 2009, and that may be leading to an unintended consequence: Some young women aren’t being screened for chlamydia, a common sexually transmitted disease that infects almost 3 million Americans every year and which, left untreated, can cause infertility.

A new study discovered chlamydia screening among 15- to 21-year-olds dropped significantly after the revised guidelines discouraged routine screening for cervical cancer before age 21, because of evidence that showed it did not benefit young women.

The guidelines are about cervical cancer detection, not chlamydia, but researchers believe that as fewer young women got Pap tests, chlamydia screening became an afterthought. The Centers for Disease Control and Prevention advises all sexually active women younger than 25 to get screened for chlamydia annually.

Though the new study is small—researchers at the University of Michigan checked five outpatient clinics connected to the university—there was a precipitous drop in chlamydia screenings at all the clinics. Providers coupled chlamydia screening with Pap testing, according to lead researcher Allison Ursu, M.D., of the university’s department of family medicine.

From 2008 to 2009, roughly 1,600 young women were seen at the clinics, and more than 500 were given chlamydia screening tests. But from 2011 to 2012—after the Pap test guidelines changed—only 37 women underwent the screening.

“It was surprising,” Dr. Ursu said. “We saw that decrease despite the fact that young women were making the same number of office visits. So there were just as many opportunities to screen for chlamydia.”

Experts says this might not necessarily reflect what’s happening nationwide. In fact, data show the national rate of screening for chlamydia has risen in recent years (though not as much as medical professionals would like. Data show less than half of sexually active women younger than 21 are being screened). But experts believe it’s a reasonable assumption that similar trends are happening at other medical centers.

The University of Michigan has taken steps to bring all clinics up to speed with current guidelines on chlamydia screening, Dr. Ursu said. She suggested that other institutions should check their screening patterns, too. This is particularly important since chlamydia doesn’t usually appear with symptoms.

Chlamydia screening is simple, and the infection is easily cured with antibiotics. Young women should talk to their doctor about being screened if their clinic doesn’t perform the test.

BHM Edit Staff