Opportunistic screening for chlamydia infection in general practice: can we reach young women?

OBJECTIVE: To study opportunistic screening in primary care, in such a way that would include teenage women. Setting-Screening for chlamydia infection was offered opportunistically in eight general practices in Edinburgh to women aged < or = 35 years attending for cervical smear, and women aged < or = 20 years attending for contraception. The numbers of women eligible to be offered screening were 901 in the cervical smear group, and 595 in the contraception group. RESULTS: Effective screening rate (offered test, consented, and urine sample returned) was 30% for the cervical smear group compared with 23% for the contraception group. Among those tested, chlamydia prevalence was strongly associated with young age, ranging from 11.8% in those <18 years, to 0% in those >25 years. Number of sexual partners in past year did not improve prediction of infection. CONCLUSION: These findings raise concerns regarding the feasibility of opportunistic screening in general practice, particularly for those with highest prevalence of chlamydia--teenage women.