Systematic reviews that have examined the effectiveness of register-based and opportunistic chlamydia screening interventions found limited supporting evidence and identified a need for higher-quality studies.[34]Low N, Bender N, Nartey L, et al. Effectiveness of chlamydia screening: systematic review. Int J Epidemiol. 2009 Apr;38(2):435-48.
https://academic.oup.com/ije/article/38/2/435/654660
http://www.ncbi.nlm.nih.gov/pubmed/19060033?tool=bestpractice.com
[35]Nelson HD, Helfand M. Screening for chlamydial infection. Am J Prev Med. 2001;20:95-107.
http://www.ncbi.nlm.nih.gov/pubmed/11306238?tool=bestpractice.com
[36]Roberts TE, Robinson S, Barton PM, et al. Cost effectiveness of home based population screening for Chlamydia trachomatis in the UK: economic evaluation of chlamydia screening studies (ClaSS) project. BMJ. 2007 Aug 11;335(7614):291.
https://www.bmj.com/content/335/7614/291
http://www.ncbi.nlm.nih.gov/pubmed/17656504?tool=bestpractice.com
[37]Taylor BD, Haggerty CL. Management of Chlamydia trachomatis genital tract infection: screening and treatment challenges. Infect Drug Resist. 2011 Jan;2011(4):19-29.
https://www.dovepress.com/getfile.php?fileID=8590
http://www.ncbi.nlm.nih.gov/pubmed/21694906?tool=bestpractice.com
In addition, one randomised controlled trial that recruited more than 2500 women between the ages of 16 and 27 years did not provide a clear answer as to whether screening for Chlamydia trachomatis is effective in reducing the incidence of PID.[38]Oakeshott P, Kerry S, Aghaizu A, et al. Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial. BMJ. 2010 Apr 8;340:c1642.
https://www.bmj.com/content/340/bmj.c1642
http://www.ncbi.nlm.nih.gov/pubmed/20378636?tool=bestpractice.com
However, a re-appraisal of evidence from randomised controlled trials of screening and controlled observational studies suggested that annual screening could prevent 61% of C trachomatis-related PID in women who became infected with C trachomatis.[39]Price MJ, Ades AE, De Angelis D, et al. Risk of pelvic inflammatory disease following Chlamydia trachomatis infection: analysis of prospective studies with a multistate model. Am J Epidemiol. 2013 Aug 1;178(3):484-92.
https://academic.oup.com/aje/article/178/3/484/98355
http://www.ncbi.nlm.nih.gov/pubmed/23813703?tool=bestpractice.com
The US Preventive Services Task Force (USPSTF) recommends that all sexually active women who are 24 years and younger, including those who are pregnant, should be screened for gonorrhoea and chlamydia. Women who are 25 years or older should be screened if they have an increased risk for infection. This includes women from a high-morbidity community (as defined by an increased prevalence) or those with individual risk factors (such as multiple recent sex partners, a history of an STI, a partner with an STI), and those connected to networks with incarcerated people, to the commercial sex trade, or to drug use.
There is minimal evidence on the effectiveness of screening for gonorrhoea or chlamydia in low-risk women.[21]US Preventive Services Task Force. Screening for chlamydia and gonorrhea: US Preventive Services Task Force recommendation statement. JAMA. 2021 Sep 14;326(10):949-56.
https://jamanetwork.com/journals/jama/fullarticle/2784136
http://www.ncbi.nlm.nih.gov/pubmed/34519796?tool=bestpractice.com