2009 Cervical Cytology Guidelines and Chlamydia Testing Among Sexually Active Young Women
ABSTRACT An American College of Obstetricians and Gynecologists Practice Bulletin published in 2009 recommended that cervical cancer screening should begin at age 21 years and women younger than 30 years should be rescreened every 2 years rather than annually. The purpose of this study is to estimate the effect that decreased frequency of cervical cancer screening would have on chlamydia screening, which is recommended annually for sexually active women aged 25 years or younger.
Using an administrative database of medical claims from commercially insured girls and women, we compared annual chlamydia screening rates of sexually active adolescent girls and young women aged 15 to 25 years in 2007 among those who underwent cervical cancer screening and those who were not screened for cervical cancer.
We identified 701,193 sexually active adolescent girls and young women aged 15 to 25 years. Chlamydia screening rates were significantly higher among adolescent girls and young women who underwent cervical cancer screening compared with those who did not: 43.6% compared with 9.5% for adolescent girls and young women aged 15 to 20 years and 36.1% compared with 12.2% for women aged 21 to 25 years. Among adolescent girls and young women identified as sexually active in 2007, 90.5% had visits for reproductive health services other than cervical cancer screening that could provide opportunities for chlamydia screening.
Although the revised American College of Obstetricians and Gynecologists Practice Bulletin recommending less frequent cervical cancer screening will likely reduce chlamydia screening rates in adolescent girls and young women, health care providers should be aware of other opportunities for chlamydial testing. Options include patient self-collected vaginal swabs and urine specimens collected during visits at which adolescent girls and young women seek other reproductive health or preventive services.
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ABSTRACT: The American Congress of Obstetricians and Gynecologists (ACOG) recently recommended that cervical cancer screening begin at 21 years of age and occur biennially for low-risk women younger than 30 years. Earlier studies suggested that women may have limited understanding of the differences between cervical cancer screening and chlamydia screening. This study assessed the knowledge of chlamydia and cervical cancer screening tests and schedules in younger women. A survey regarding knowledge of chlamydia and cervical cancer screening was administered to 60 younger women aged 18-25 years in an obstetrics and gynaecology clinic at an urban community health centre. The majority of respondents recalled having had a Pap smear (93.3%) or chlamydia test (75.0%). Although many respondents understood that a Pap smear checks for cervical cancer (88.3%) and human papillomavirus (68.3%), 71.7% mistakenly believed that a Pap smear screens for chlamydia. No respondent correctly identified the revised cervical cancer screening schedule, and 83.3% selected annual screening. Few respondents (23.3%) identified the annual chlamydia screening schedule and 26.7% were unsure. Many younger women in an urban community health centre believed that cervical cancer screening also screens for chlamydia and were confused about chlamydia screening schedules. As there is limited knowledge of the revised ACOG cervical cancer screening guidelines, there is a risk that currently low chlamydia screening rates may decrease further after these new guidelines are better known. Obstetrician gynaecologists and primary care providers should educate younger women about the differences between chlamydia and cervical cancer screening and encourage sexually active younger women to have annual chlamydia screening.Sexually transmitted infections 11/2011; 88(1):35-7. DOI:10.1136/sextrans-2011-050289 · 3.08 Impact Factor
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ABSTRACT: Objetivo: Establecer la asociación entre la infertilidad tubarica y la infección cervical por Chlamydia trachomatis (CT) o Ureaplasma urealiticum (UU), en mujeres infértiles. Métodos: Investigación comparativa y aplicada, con diseño de tipo no experimental, de casos y controles, contemporáneo transeccional y de campo, que incluyó 60 mujeres, separadas en dos grupos pareados de acuerdo si eran infértiles (casos) o fértiles (controles), a las cuales se les tomó una muestra de hisopado endocervical para el diagnóstico molecular de CT o UU y se les realizó una histerosalpingografía para evaluar la permeabilidad de las trompas uterinas. Resultados: Se detectó una prevalencia en mujeres infértiles y fértiles de infección por CT o UU del 18% y 35%, respectivamente; siendo mayor entre las mujeres infértiles, diferencia significativa solo para UU (p<0,05). Se detectó una mayor permeabilidad tubárica en las pacientes fértiles que en las infértiles (80% vs. 40%), siendo el compromiso tubárico mayor en las pacientes infértiles (p<0,05). Al asociar el diagnóstico de CT o UU con los resultados de la histerosalpingografía se constató que la detección de uno de estos microorganismos aumentaba casi 3 o 5 veces más la probabilidad de presentar obstrucción tubárica, respectivamente, diferencias no significativas (p>0,05). Conclusión: Una gran parte de las mujeres infértiles presentan infección por CT o UU, patógenos de transmisión sexual que pudiesen tener responsabilidad en el daño tubárico.Revista Chilena de Obstetricia y Ginecologia 12/2012; 78(1):32-43. DOI:10.4067/S0717-75262013000100006
- Sexual Health 07/2013; DOI:10.1071/SH12191 · 1.58 Impact Factor