Trial Shows Benefits of Concurrent Pap Smears and Chlamydia Screening
A study conducted in the Australian Capital Territory (ACT) has shown that the rate of chlamydia screening in eligible women could double if the screening was conducted at the same time the women visit their general practitioner for Pap smears.
The study, which randomised 31 ACT general practices to offer either opportunistic chlamydia screening or screening at the same time as a routine Pap smear, was conducted by a research team from the Australian National University (ANU) and is published in the latest edition of the Medical Journal of Australia.
Professor of Medicine at the ANU Medical School, Francis Bowden, said that eligible women who attended GP practices that were allocated to the combined Pap/chlamydia testing arm were twice as likely to be screened for chlamydia than women who attended the practices in the opportunistic arm.
"Although combining the two tests has been considered in the past . . . the ability of this approach to increase chlamydia screening has not been formally investigated in general practice," Professor Bowden said.
"This is not the final answer to chlamydia screening, as the infection occurs most commonly in the 16 to 25 year old age group and women less than 20 years are less likely to have a Pap smear and men are not directly targeted; but for women in the 20 to 30 year age group this is an easy way to ensure regular chlamydia screening.
"Implementing this approach requires little additional infrastructure support in settings where a cervical cancer screening program already exists (such as Australia) and the combination could become a 'default' position of women undergoing Pap screening."
Chlamydia screening, undertaken as part of routine health care for young women, can reduce the incidence of pelvic inflammatory disease and ectopic pregnancy.
Despite this knowledge, notifications of genital chlamydial infection have increased at least five fold in Australia in the past decade and there are now over 40,000 cases reported each year.
Chlamydia prevalence is estimated to be at least 1.5%-3.2% per cent in the general population, and the reported median prevalence in general practice is 4.6% in the United Kingdom, 1.0%-5.6% in the United States, and 1.5% in Australia.
The Medical Journal of Australia is a publication of the Australian Medical Association.