ACOG: Region Should Factor Into Chlamydia Screening Guidelines For Women Over Age 25

Women over the age of 25 may still need to be screened for Chlamydia trachomatis (CT) according to research released at the American Congress of Obstetricians and Gynecologists’ (ACOG) Annual Clinical Meeting. This contradicts most current guidelines, including guidelines from ACOG and U. S. Preventative Services Task Force (USPSTF) which indicate CT screening only for women younger than 25.

The study was a retrospective analysis, and CT rates from 40 states were recorded from January 2010 through January 2011. CT testing was performed at a single commercial laboratory, and a total of 326,601 women were tested. 
Overall, 2.2% of tests were positive (7185), with 4.9% of tests positive in women under 26 years of age (105,921) and .9% positive in patients older than 25.

Although there was a significantly higher rate of CT in younger women, results varied widely by region. Arkansas, Louisiana, and Mississippi had CT rates of ≥10% in women <26. In eight states, including Arkansas, Delaware, Minnesota, New Hampshire, New Mexico, and Wisconsin, women over the age of 25 had a CT rate of ≥2%.

Lead author Mark Martens, MD, of the Jersey Shore Medical Center in Neptune, New Jersey, concluded that testing guidelines should not be exclusively determined by age, but should take region into account. "Chlamydia is known to vary by age and race, but also by region,” he said. “To look at screening just by age is simple and easy, but we also have to look at what's the most cost-effective use for our dollars."

He also suggested that state-by-state marriage and divorce trends could play a role in the differing rates of infection.