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Fresh doubt over chlamydia screening

The national chlamydia screening programme is not underpinned by sound clinical evidence, a leading public health expert has claimed.

Dr Nicola Low, a member of the Government-funded Chlamydia Screening Studies evaluation group, warned England's opportunistic screening programme was based on 'uncritical acceptance of the effectiveness of chlamydia screening before the benefits and harms were evaluated'.

Dr Low, a reader in epidemiology and public health at the University of Bern in Switzerland, said her conclusions in last week's BMJ did not preclude from testing for chlamydia when appropriate.

She said: 'Testing for chlamydia when appropriate is part

of good sexual healthcare. The people who I think need to be questioned are the Department of Health and the National Screening Committee, as to why they implemented a programme in the absence of any evidence.'

In an accompanying editorial, Dr Rachael Jones and Dr Fiona Boag, consultants in genitourinary medicine at the Chelsea and Westminster Hospital in London, warned opportunistic approaches to screening 'have little evidence to support them', concluding:

• participation of GPs is lower than in pilots

• low number of men screened

• contact tracing has failed to reach all partners

• chlamydia screening is not cost-effective

• opportunistic screening has not been evaluated in randomised controlled trials.

• Visit for evidence-based data on chlamydia

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