EDITOR—Pimenta et al, in their evidence based health policy report, argue that opportunistic screening for Chlamydia trachomatis, targeting young women in primary care, “heralds the approach that is required to manage the wide variety of sexual health issues that confront us today.”1 This conclusion is premature when the pilot studies described are not completed and unanswered questions remain.

It is uncertain whether opportunistic screening of young women can control the chlamydia epidemic. The only randomised trial of screening did not evaluate an opportunistic approach and included in the analysis only a small proportion of the women randomised.2 Opportunistic screening in Sweden did reduce rates of infections and complications,3 but recent figures indicate a resurgence …