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2009 Pap Guidelines Linked to Drop in Chlamydia Testing

Screening of young women dropped significantly at one university health center

TUESDAY, July 21, 2015 (HealthDay News) — A major change in Papanicolaou (Pap) test guidelines introduced in 2009 may have had an unintended consequence: Some young women are missing out on screening for chlamydia, according to a report published in the July/August issue of the Annals of Family Medicine.

This is according to a small, new study that indicates chlamydia screening among 15- to 21-year-olds dropped significantly after national guidelines were changed to discourage routine Pap screening for cervical cancer before age 21, because of evidence that showed it did not benefit young women. However, the U.S. Centers for Disease Control and Prevention and other groups advise all sexually active women younger than 25 to get an annual chlamydia screening test. Yet in the new study, researchers at the University of Michigan saw a precipitous drop in chlamydia screening at five outpatient clinics connected to the university.

Of 1,626 young women seen at the clinics from 2008 to 2009, 502 were given chlamydia screening tests. But from 2011 to 2012 — after the Pap test change — only 37 of 1,846 young women underwent chlamydia screening.

It seems that providers there were in the practice of “coupling” chlamydia screening with Pap testing, lead researcher Allison Ursu, M.D., of the university’s department of family medicine, told HealthDay. “It was surprising,” Ursu said. “We saw that decrease despite the fact that young women were making the same number of office visits. So there were just as many opportunities to screen for chlamydia.”

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