SECAUCUS, N.J., Sept. 3, 2020 /PRNewswire/ -- The rate at which
women 18-30 years of age tested positive for the two most common
reportable sexually transmitted infections grew by double digits
between 2010 and 2017, finds an analysis of nearly 18 million
de-identified test results from Quest Diagnostics (NYSE: DGX).
The new Health Trends® study from Quest Diagnostics
is believed to be one of the largest to examine rates of clinical
laboratory test results for Chlamydia trachomatis
(chlamydia) and Neisseria gonorrhoeae (gonorrhea) on a
national scale. The study examined 17,794,680 co-testing laboratory
results for both infections from females aged 12–30 years tested at
Quest Diagnostics during 2010–2017.
The study is available in the American Journal of Preventive
Medicine (AJPM) online ahead of print here.
In addition to showing sharp increases in the positivity rates
of chlamydia and gonorrhea, the study also found that the
positivity rates of both infections shifted toward older ages over
the eight-year study period. This observed shifts in age-based risk
is significant because it raises the prospect that current medical
guidelines for screening are not aligned with the sexual behaviors
of, and associated risk of infection in, women in the United States.
Guidelines from the Centers for Disease Control and
Prevention (CDC) and the U.S. Preventive Services Task Force
(USPSTF) recommend annual screening for both infections in all
sexually active women younger than 25 years of age. Screening in
women 25 years of age and older is recommended only for those with
certain risk factors, such as a new or multiple sexual partners or
inconsistent condom use.
Yet, according to the study, the positivity rate for chlamydia
for 27-year-old women in 2017 (3.5%) was the same as the positivity
rate for 24-year-old women in 2010. A similar dynamic was observed
for gonorrhea infections, with the positivity rate in 30-year-olds
in 2017 (0.5%) identical to that found in 23-year-olds in 2010.
Overall, the peak age of positivity for both infections
increased by one to two years and, in test results at the farthest
distribution, by 3 to 7 years for chlamydia and gonorrhea
respectively, over the eight-year study period.
Infections with chlamydia and gonorrhea often lack symptoms and,
left untreated, may result in pelvic inflammatory disease and
infertility.
"Our Health Trends data shows that sexually transmitted
infections do not discriminate by age," said lead researcher
Harvey W. Kaufman, M.D., Senior
Medical Director and Director, Health Trends Research Program at
Quest Diagnostics. "When a sexually transmitted infection goes
undetected and untreated, the result can be long-term health
problems such as infertility and unknowing transmission of the
infection to others. Sexual behaviors have changed in the United States, and guidelines need to
reflect that women may be spending longer periods of time being
sexually active and with more partners prior to childbearing than
in the past."
Among the key findings:
- The annual chlamydia positivity rate increased by 18 percent
overall (4.9% in 2010 to 5.8% in 2017), while annual gonorrhea
positivity increased by 33 percent overall (0.7% in 2010 to 0.9% in
2017).
- Although women ages 18-24 were more likely to test positive for
either infection, women 25-30 years of age experienced a higher
increase over the 8-year period. Among women 25-30 years of age,
the positivity rate increased by 50 percent (from 2.2% in 2010 to
3.3% in 2017), compared to women in the 18-24 age group, at 21
percent (6.1% to 7.4%).
- Among the youngest (12-17) age group, the positivity rate
declined 17 percent for chlamydia (8.9% in 2010 to 7.4% in 2017)
and 14 percent for gonorrhea (1.33% in 2010 to 1.17% in 2017).
"Our analysis raises the possibility that some women in
the United States are prematurely
aging out of access to annual screening, given current guidelines,"
said co-author Damian P. Alagia,
III, M.D., Senior Medical Director of Woman's Health for
Quest Diagnostics. "As such, women over the age of 24 years
can only access testing if they are symptomatic or labeled 'high
risk' by their healthcare provider following a potentially
uncomfortable dialogue about their sexual behavior. Given changing
sexual mores, a more thoughtful and inclusive population screening
approach supporting screening access for women above the age of 24
years is overdue."
The study, "Chlamydia and Gonorrhea: Shifting Age-Based
Positivity among Young Females, 2010-2017," is available at:
https://www.sciencedirect.com/science/article/pii/S0749379720302713#!
Approximately 1,760,000 cases of chlamydia and 583,000 cases of
gonorrhea infections were reported to the Centers for Disease
Control and Prevention in 2018.
About Quest Diagnostics
Quest Diagnostics empowers
people to take action to improve health outcomes. Derived from the
world's largest database of clinical lab results, our diagnostic
insights reveal new avenues to identify and treat disease, inspire
healthy behaviors and improve health care management. Quest
annually serves one in three adult Americans and half the
physicians and hospitals in the United
States, and our 47,000 employees understand that, in the
right hands and with the right context, our diagnostic insights can
inspire actions that transform lives. www.QuestDiagnostics.com.
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