Screening for chlamydial infection: an evidence update for the U.S. Preventive Services Task Force.
BACKGROUND
Chlamydial infection is the most common sexually transmitted bacterial infection in the United States, with an estimated 3 million new cases annually. In 2001, the U.S. Preventive Services Task Force (USPSTF) recommended that clinicians screen all sexually active women at increased risk for infection for Chlamydia trachomatis.


OBJECTIVE
To summarize a systematic evidence review commissioned by the USPSTF in preparation for an update of its 2001 recommendation.


METHODS
English-language articles identified in PubMed between July 2000 and July 2005. Additional articles were identified by bibliographic reviews and discussions with experts. A total of 452 articles were identified.


METHODS
Explicit inclusion and exclusion criteria were used for each of 3 key questions. For studies of screening in nonpregnant women at increased risk, review was limited to randomized, controlled trials. For other groups, both randomized, controlled studies and nonrandomized, prospective, controlled studies were included.


METHODS
Using standardized forms, staff of the Agency for Healthcare Research and Quality abstracted data on study design, setting, sample, randomization, blinding, results, and harms.


RESULTS
Only 1 new study met inclusion criteria. This poor-quality study of the effectiveness of screening for chlamydial infection among nonpregnant women at increased risk found that screening was associated with a lower prevalence of chlamydial infection and fewer reported cases of pelvic inflammatory disease at 1-year follow-up.


CONCLUSIONS
No new evidence was found on screening in pregnant women, nonpregnant women not at increased risk, or men.


CONCLUSIONS
A systematic review found a small amount of new evidence to inform the USPSTF as it updates its recommendations regarding screening for chlamydial infection. There are large gaps in the evidence about screening men to improve health outcomes in women.
Meyers
David S
DS
Center for Primary Care, Prevention, and Clinical Partnerships, Agency for Healthcare Research and Quality, Rockville, Maryland 20850, USA.
Halvorson
Heather
H
Luckhaupt
Sara
S
D000293:Adolescent; D002690:Chlamydia Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D017281:Cost of Illness; D019317:Evidence-Based Medicine; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D008297:Male; D008403:Mass Screening; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D014481:United States / Q000453:epidemiology