San Diego, CA -- Adolescents and young women are not being routinely screened for chlamydia, said experts today at a news briefing held during The American College of Obstetricians and Gynecologists' (ACOG) 55th Annual Clinical Meeting in San Diego. Each year an estimated 2 million cases of chlamydia go undiagnosed and untreated, leading to serious health consequences for women. More attention needs to be focused on getting adolescent girls and young women screened yearly for chlamydia.

"Although ACOG, the Centers for Disease Control and Prevention (CDC), and the US Preventive Services Task Force recommend annual screening for chlamydia of all sexually active women age 25 and younger, as well as other asymptomatic women at high risk for infection, studies show it isn't happening," said Stanley Zinberg, MD, MS, ACOG's deputy executive vice president and vice president for practice activities in Washington, DC.

According to the National Center for Health Statistics (NCHS), chlamydia remains the most commonly reported STD in the US. In 2005, there were just over 976,000 reported chlamydial infections, but because many cases are not diagnosed or reported, there may be as many as 2.8 million new cases annually. About 75% of chlamydial infections in women don't produce symptoms or if they do, they are often vague, causing women to delay seeking medical care and treatment. If not treated, up to 40% of women infected with chlamydia may develop pelvic inflammatory disease (PID), which can lead to ectopic pregnancy and infertility. One in five women with PID becomes infertile.

Chlamydia is caused by bacteria and is passed from person to person through sex, as is gonorrhea, another bacterial STD. Both chlamydia and gonorrhea infect the same sites in a woman's reproductive tract and are often diagnosed and treated together.

"Statistically, adolescent girls in the US ages 15-19 have the highest reported rates of chlamydia," said David E. Soper, MD, professor of ob-gyn at the Medical University of South Carolina in Charleston. "Many STDs go undiagnosed because most cases don't produce symptoms, so the actual rates are undoubtedly much, much higher. With chlamydia, like many STDS, the health consequences can be devastating. This is why it's important that all sexually active adolescents and young women age 25 and younger get screened annually for chlamydia."

A study sponsored by the CDC and the Agency for Healthcare Research and Quality lists chlamydia screening as one of the top most effective but underutilized preventive health services. It found that chlamydia screening provides great health benefits, both in terms of improving quality of life and offering the most value for health care dollars. "More than half of sexually active women age 25 and younger have not been screened for chlamydia, according to the report," Dr. Zinberg said. "An estimated 60,000 cases of PID, 8,000 cases of chronic pelvic pain, and 7,500 cases of infertility would be prevented annually if the recommended chlamydia screening guidelines were followed."

"An important message for everyone, and adolescents in particular, is that screening for chlamydia is as simple as a urine test, and a short course of antibiotics cures it," said Laura E. Riley, MD, an expert in infectious diseases and assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School in Boston, MA. "Discussing sexual activity is not easy for a lot of people, but being honest with your physician and getting tested are imperative for good health and future fertility.

"Chlamydial infections also can cause problems during pregnancy," Dr. Riley continued. "Untreated chlamydia increases the risk of premature rupture of membranes. Babies born to women with chlamydia have a 40% chance of developing conjunctivitis, an infection of the lining of the eye. While this problem can be easily treated with medicated eye drops, some babies born to infected women can develop pneumonia, which is very grave for a newborn."

The experts say there may be a number of reasons why physicians aren't screening for chlamydia, including the belief that STD prevalence is low in their practice. "As physicians, we need to dispel the stigma and bias that so often surround STDs," remarked Dr. Soper. "The reality is that STDs are diseases of humanity. Humans become infected doing what humans do. If the doctor doesn't bring the subject up, women should ask to be screened without embarrassment."

In addition to annual screening, STD prevention counseling is also important. Short of abstinence and monogamy, condom use during every instance of sexual contact, including oral sex, is the best way to prevent STDs, including chlamydia, gonorrhea, and HIV, according to Dr. Soper.

In all 50 states and the District of Columbia, testing and treatment for STDs can be provided to adolescents without parental consent or knowledge. While no state requires that physicians notify parents that an adolescent is seeking or receiving STD services, 18 states allow physicians to do so if they deem it in the best interests of the minor.

"The bottom line is that young women need to be up front with their physician about their sexual behavior and proactive during the annual gynecologic exam to make sure that they are tested for chlamydia," Dr. Riley said.

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