Current recommendations from the United States Public Health Service and professional medical societies call for routine screening for chlamydia and gonorrhea in all sexually active females under age 20, since these diseases often are asymptomatic. In some higher risk populations of teens it has been suggested that such screening take place every six months. "Urine tests would make this much more feasible, by expanding the number of young women who get routine tests," Shafer said.

"Also, resources can be directed to screening boys as well as girls," she said. "And doctors will have more time to spend on counseling, reminding their young patients to try to abstain from sex, to use condoms consistently if they have sex, and not to have sex with people they don't know."

Testing and treatment of early cases of STDs is recommended as part of a strategy that also includes primary prevention - assisting youth to delay the onset of sexual activity, and encouraging sexually active adolescents to use condoms and limit the numbers of their sexual partners.

However, prevention efforts, including screening, still do not reach many young people. Recent studies have shown that only half of at-risk teens are screened for STDs during routine health exams, and almost 40 percent of pediatricians never perform pelvic exams upon their sexually active adolescent patients who need them.

Pelvic exams are used to detect other diseases that a urine test could not pick up, including cervical cancer. However, this cancer is so rare among young women that it would take one-half million pelvic exams with Pap smears to detect one case, the researchers noted. They suggested pelvic exams for young women who may be at risk for cervical cancer. But for the general population, the
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Contact: Janet Basu
janbasu@itsa.ucsf.edu
415-476-2557
University of California - San Francisco
16-Feb-1999