Opportunistic screening for chlamydia infection in general practice: can we reach young women?

To study opportunistic screening in primary care, in such a way that would include teenage women. Setting-Screening for chlamydia infection was offered opportunistically in eight general practices in Edinburgh to women aged < or = 35 years attending for cervical smear, and women aged < or = 20 years attending for contraception. The numbers of women eligible to be offered screening were 901 in the cervical smear group, and 595 in the contraception group.

Effective screening rate (offered test, consented, and urine sample returned) was 30% for the cervical smear group compared with 23% for the contraception group. Among those tested, chlamydia prevalence was strongly associated with young age, ranging from 11.8% in those <18 years, to 0% in those >25 years. Number of sexual partners in past year did not improve prediction of infection.

These findings raise concerns regarding the feasibility of opportunistic screening in general practice, particularly for those with highest prevalence of chlamydia--teenage women.