[Screening for Chlamydia trachomatis infection: which group should be targeted and at what price?]

This journal issue features three articles on screening in Amsterdam, the Netherlands, for infection with Chlamydia trachomatis (CT): one on opportunistic screening (patients were invited to participate who consulted a general practitioner for other causes), one on the cost/benefit analysis of such screening, and one on systematic screening (all people registered in general practices were asked to mail a urine sample). The prevalence of CT infection was 8.7% in the opportunistic screening for all women aged 15-24 years, and 4.2% in the systematic screening for all women aged 15-25 years. Cost/benefit analysis appears to indicate that screening of women younger than 30 years may be cost effective. However, it seems to be too early to start a large screening programme, as it is not known whether repeated screening is needed, whether contacts should be included, whether the opportunistic approach reaches enough people in the target population, and whether the screening should be limited to the large cities.