It has been recommended that all sexually active women under the age of 25 be screened for Chlamydia. The reason being that most initial infections in women are asymptomatic but may progress to more serious diseases such as pelvic inflammatory disease, ectopic pregnancy, infertility, and chronic pelvic pain.

In the recent issue of the Annals, this strategy has proven to be cost-effective and only emphasizes the importance of general screening – which has been neglected in general practice:

However, despite data and recommendations that strongly support the benefits and cost-effectiveness of screening in this high-priority group, actual practice falls far short of recommended practice. Public health–based screening programs in many communities are underfunded, and too many of them can offer screening to less than half the target population. The medical practice community is no better than the public health system: Few physicians offer screening to their sexually active patients 15 to 24 years of age.

Screening can now be accomplished on first-void urine samples, so there should no longer be an excuse to miss screening opportunities.