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By Merritt McKinney
NEW YORK, Mar 26 (Reuters Health) - Many young women are not being screened for chlamydia, a sexually transmitted disease that is easy to treat with antibiotics but has dangerous consequences if left untreated, a survey of Pennsylvania doctors has found.
Two out of three primary care physicians surveyed did not screen sexually active teenage women for chlamydia, Dr. Robert L. Cook of the University of Pittsburgh and colleagues report in the March issue of the Journal of Adolescent Health.
From 2% to 20% of women aged 15 to 24 have chlamydia, making it one of the most common sexually transmitted diseases. The infection often goes undetected, because most women with chlamydia have no symptoms.
If left untreated, 20% to 40% of women with chlamydia will go on to develop pelvic inflammatory disease, which can cause infertility and chronic pelvic pain. Preliminary evidence has linked chlamydia infection with increased cervical cancer risk. Infection with chlamydia may also increase the risk of being infected with HIV, the virus that causes AIDS.
Because early treatment can reduce the risk of these complications, the Centers for Disease Control and Prevention in Atlanta, Georgia, and other public health groups recommend that all sexually active adolescents be screened for the disease.
But many doctors who treat sexually active teens are not following that advice.
In a survey of 546 primary care physicians, including internists, family physicians, pediatricians and obstetrician/gynecologists, only 32% said that they would screen a sexually active teenage girl for chlamydia as part of a routine gynecologic examination if she did not have any symptoms.
Female physicians, doctors working in clinics or group practices, and physicians in metropolitan areas were more likely to offer screening, the survey found. Physicians who had a greater proportion of African-American women in their practice were also more likely to recommend the test.
Cook's team also found that physicians who believed that most 18-year-old patients were not sexually active or that the rate of chlamydia was too low to make screening effective were less likely to offer the screening test.
"They don't think it is common in their (patient) population," Cook told Reuters Health in an interview. But almost two thirds of 18-year-old women have had sex, the authors note in the report.
"The study's findings strongly suggest that physician adherence to chlamydia screening guidelines for teenage women is inadequate and must be improved," Cook and colleagues conclude.
Although it is important to educate doctors about the need for screening sexually active young women, Cook said that women should not wait for doctors to bring up the subject.
"A lot of women see physicians for general gynecologic exams and don't know what they're getting tested for," he said. Cook encouraged young women to ask their doctor if he or she is doing a chlamydia test.
Cook noted that while men can contract chlamydia, women are more likely to suffer severe health consequences as a result of the infection.
SOURCE: Journal of Adolescent Health 2001;27:204-210.
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