TP 5 Evaluating Differences in Chlamydia Screening Among Older Women Attending Family Planning (FP) Clinics By U.S. Public Health Service (USPHS) Region, 2010

Tuesday, June 10, 2014
Pre-function Lobby (M2)
Robyn Neblett Fanfair, MD, MPH1, David Fine, PhD2, LaZetta Grier, BA3, Sarah Salomon, MPH2, Wendy Nakatsukasa-Ono, MPH2, Patricia Blackburn, BA4, Elizabeth Torrone, PhD5 and Lauri Markowitz, MD6, 1DHHS/CDC/OID/NCHHSTP/DSTDP/ESB, CDC, Atlanta, GA, 2Cardea Services, Seattle, WA, 3SDMB, DHHS/CDC/OID/NCHHSTP/DSTDP/SDMB, Atlanta, GA, 4Cardea, Oakland,, GA, 5Division of STD Prevention, CDC, Atlanta, GA, 6Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA

Background:  CDC recommends screening all sexually active women aged <26 years and older women with risk factors for Chlamydia trachomatis (CT). Evidence suggests too few women receive age-appropriate CT screening while older women may be overscreened. We evaluated differences in CT screening among women aged >25 years across 10 USPHS regions and assessed the proportion of tests that may reflect overscreening in one region.

Methods:  We analyzed all CT tests performed among women attending FP clinics participating in national infertility prevention activities in 2010.  We calculated the proportion of CT tests performed by age categories (<26 years, >25 years,) for each region. In Region X (the Pacific Northwest) we assessed the proportion of CT tests in women >25 years that did not have any clinical or behavioral risk factors and may represent overscreening events.

Results:  A total of 1,619,275 CT tests were performed in the FP clinics in 2010 with 28.4% performed in women >25 years. Testing in older women ranged from 13.0% (Region VII) to 33.0% (Region IV). In Region X, 20.5% (n=16,257) were performed in women aged >25 years. Of these, 72.3% (n=11,758) had an identified risk factor justifying CT testing; 3.7% (n=2,947) of all Region X CT tests could be defined as overscreening events. CT positivity was 3.6% among women aged >25 years that met risk criteria compared to 2.1% among those over-screened.


In FP clinics, the proportion of CT tests performed in older women varied significantly by region. However, overscreening events may be uncommon as nearly three-quarters of older women screened in Region X had an identified risk factor. Further investigation of testing in older women in other clinical settings is warranted to see if there are high levels of overscreening.