Chlamydia screening ‐ benefits and strategy need to be re‐evaluated?

Abstract

This document is made available in accordance with publisher policies and may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the URL above for details on accessing the published version. Copyright and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable, the material made available in SRO has been checked for eligibility before being made available. Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. E ngland's National Chlamydia Screening Programme (NCSP) occupies a uniquely challenging place within health policy. The UK National Screening Committee, whose responsibility for setting screening policy is recommended as a model for Europe, 1 has not been involved in initiating the NCSP. Its guidance remains that chlamydia screening should not be offered in pregnancy, and it describes the NCSP not as a screening programme, but as a 'communicable disease control programme'. 2 Its most recent review in 2002 did not recommend general population screening for chlamydia. This presents a challenge to the NCSP rollout, in the risk of being cut adrift from the mainstream of screening policy and practice in the UK, and from a wealth of experience in the development and management of sustainable screening programmes. The management of the NCSP is also unique among screening programmes in being managed by the Health Protection Agency, an 'arms-length' body that has limited direct control over, or accountability for, NHS outcomes or practice, 3 and that does not manage any of the other existing large-scale screening programmes. Is opportunistic screening effective? This comes at a time when reviews of recent evidence have cast doubt on the evidence base for the current approach to chlamydia screening. 'Proactive' models of screening use population registers to identify a target population, and invite people personally to participate. 1,4 This is the overarching strategy used for programmes approved by the National Screening Committee. 'Opportunistic' screening involves …