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Single sample doubles as cervical and chlamydia screen

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Screening for chlamydia is potentially possible at first invitation for cervical screening with a liquid based system for collecting samples, a feasibility study in England has shown. The National Institute for Clinical Excellence has since approved liquid based cytology for national cervical screening.

Samples obtained by conventional means for chlamydia testing and by the ThinPrep Pap test system for cervical screening, when tested for chlamydial DNA by ligase chain reaction (LCR), all showed concordant results between sample pairs. Nineteen were positive for chlamydia and 562 negative out of 581 samples. A subset of 16 positive samples stored at ambient temperature remained positive for at least five months—the time of reporting. The double call-recall service for chlamydia and cervical smears that is provided locally would be an issue for national screening, though, the authors predict.

Three colposcopy services—two hospital services and a community based service—in Wirral, north west England, took part. The study directly compared suitability of residual sample from the ThinPrep test system with a paired conventional swab sample taken immediately afterwards for detecting chlamydia by standard LCR during May 2001–2. The ThinPrep test system uses a sampling device to collect cervical cells into a transport medium for later cytological examination.

Detecting chlamydia early would reduce potential complications of the infection and public health costs of about £100m a year. The study extends a government funded pilot screening programme with the LCR system within a national strategy to improve sexual health.

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