Proactive Chlamydia Screening Is Not Cost-effective

Editor's Choice
Main Category: Sexual Health / STDs
Also Included In: Women's Health / Gynecology;  Public Health
Article Date: 27 Jul 2007 - 2:00 PDT


Two types of screening exist - proactive and opportunistic. Proactive screening invites individuals to be screened regularly, they are called from population registers. Opportunistic screening proposes screening to people as they attend health services for unrelated reasons.

A study published in the British Medical Journal (BMJ) concludes that proactive screening is not cost-effective.

Opportunistic Chlamydia screening is more common in England. However, some general practice registers are being utilized to invite people for proactive screening.

Studies in the past have mostly indicated that Chlamydia screening is good value for money, but certain doubts have recently been raised about how true this might be. The researchers in this latest study decided to compare the value for money of proactive screening against no organized screening.

With the aid of a mathematical model, a hypothetical population of 50,000 people, aged 16-24, males and females, were offered screening proactively. They employed a dynamic model to give the nearest possible approximation to the real sexual behavior of these 50,000 people. This study differed from previous ones in that only static models had been used before to for evaluating an infectious disease.

The screenings' cost-effectiveness was a based on how many major outcomes it might prevent - such as pelvic inflammatory disease, ectopic pregnancy, infertility, or neonatal complications.

For screening both sexes, the incremental cost-effectiveness ratio per major outcome averted after 8 years was about £28,000, when compared to no organized screening (screening just women £22,300). The most frequently averted outcome was pelvic inflammatory disease.

When the rate of major complications and uptake of screening were increased (to values which would not happen in real life), cost-effectiveness ratios dropped to £6,200 per major outcome (screening only women).

"Our evaluation of proactive population chlamydia screening, using a dynamic model incorporating realistic estimates of partner notification, the uptake of screening, and the incidence of severe complications, has shown it to be an expensive intervention that probably does not represent good value for money," the authors conclude.

"Cost effectiveness of home based population screening for Chlamydia trachomatis in the UK: economic evaluation of Chlamydia screening studies (ClaSS) project"
BMJ Online First
http://www.bmj.com

Written by: Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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