BMJ  2007;334:725-728 (7 April), doi:10.1136/bmj.39154.378079.BE

Analysis

Screening programmes for chlamydial infection: when will we ever learn?

Nicola Low, reader in epidemiology and public health

Department of Social and Preventive Medicine, University of Bern, Bern, CH-3012, Switzerland

Correspondence to: low@ispm.unibe.ch

With more countries recommending screening programmes for chlamydial infection, Nicola Low argues that such programmes are not underpinned by sound evidence

The first 150 words of the full text of this article appear below.

The notion that a programme of widespread screening1 in Sweden controlled transmission of chlamydial infection and reduced morbidity of the female reproductive tract is commonly cited as fact.2 3 4 Unfortunately, this assertion and similar claims about screening in the United States3 4 5 and Canada6 are not supported by rigorous research or practice. Here, I will show how misinterpretation of what comprises a screening programme led to uncritical acceptance of the effectiveness of chlamydia screening, and the funding of a National Chlamydia Screening Programme in England,3 before the benefits and harms were evaluated.


Lack of an agreed concise definition of a screening programme has contributed to beliefs about the effectiveness of opportunistic screening for chlamydial infection
Opportunistic screening as currently implemented in the National Chlamydia Screening Programme in England has not been evaluated in randomised controlled trials
Criteria for assessing the appropriateness for introducing a screening programme have not been rigorously applied to . . . [Full text of this article]



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