Chlamydia Screening: Expanding the Scope

Genital Chlamydia trachomatis infection remains themost commonly reported infectious disease in the United States, with an estimated annual incidence of at least 3 million cases and annual related costs exceeding $2 billion (1, 2). Most initial infections in women are asymp-tomatic but may progress to serious sequelae, mainly pelvic inflammatory disease, ectopic pregnancy, infertility, and chronic pelvic pain. Without an effective vaccine, preven-tion programs have focused primarily on screening and treating young women, the highest-risk group in terms of prevalence and complications (3). Such programs have re-duced the occurrence of pelvic inflammatory disease, have reduced the overall prevalence of chlamydia in the screened population, and have been cost-effective (3, 4). Current guidelines from the U.S. Preventive Services Task Force thus recommend annual screening of all sexually activ