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Minnesota doctors debate screening all young adults for chlamydia

Screening all of Minnesota's young adults for chlamydia would be a positive step, the manager of a health clinic for teenagers said on Thursday.

"I really like it," said Caroline Woods, a physician's assistant who manages the Lutheran Social Service Wellness Center at 104 W. First St.

"I'm recommending screening for everybody, every shape, size, sexual orientation," Woods said. "Everybody -- I'm recommending that they get screened."

Chlamydia, a sexually transmitted disease, is widespread in Minnesota. Left untreated, it can cause serious complications in women, including pelvic inflammatory disease and infertility. Caught early, it's easily treated, and current screening methods are simple and non-invasive. But fewer than 60 percent of females younger than 25 are screened. Often it produces no symptoms, so people who are infected may spread chlamydia without knowing it.

The Minnesota Medical Association's House of Delegates, which is meeting at the Duluth Entertainment Convention Center, will vote today on a resolution that would back annual chlamydia screening for everyone from ages 15 to 25 -- whether male or female, whether sexually active or not.

If they did so, the state's doctors would be going beyond national guidelines, which recommend screening only females who are sexually active.

The resolution is in response to what Candy Hadsall of the Minnesota Department of Health calls a "chlamydia epidemic" in the state. More than 15,000 cases were reported in the state last year, and "it's almost tripled in the last 12 years," said Hadsall, who was part of a steering committee that wrote "The Minnesota Chlamydia Strategy" in April.

But several doctors who spoke at a committee meeting Thursday afternoon were dubious.

Dr. Sally Trippel of the Mayo Clinic agreed that chlamydia is a serious problem, but she said the resolution overreached.

"This resolution is asking the MMA House of Delegates to create a new guideline," Trippel said. "And I would argue that that's not the purpose of the House of Delegates. We don't have the expertise."

Both the U.S. Preventive Services Task Force and the Centers for Disease Control and Prevention guidelines recommend screening sexually active females ages 15 to 25, Trippel said. Screening males hasn't been proven cost-effective in existing studies, she said.

Dr. Amy Gilbert of St. Paul, who presented the resolution for the MMA's public health committee, already had acknowledged that issue.

"We have to confess that the data on the benefits of screening males is not as strong," Gilbert said. "It comes from more of a felt sense that ... by screening males we would catch more and eliminate more chlamydia from the population."

Dr. Terence Cahill of Blue Earth, chairman of the committee, said such screenings put doctors in an uncomfortable position, especially in rural communities. "I have to call the parent and explain why I'm screening their child for a sexual disease," he said. "This proposal would have us screening for a disease that a significant number of people don't have or aren't likely to have."

But that's why everyone should be screened, Gilbert said. "Part of the value of making it routine is you can say, 'I just test everyone.' "

Chlamydia isn't restricted to cities and suburbs, Hadsall said in a telephone interview. One-third of the cases are reported in Minneapolis and St. Paul, one-third in the Twin Cities suburbs, and the remainder are spread through the rest of the state.

Woods said she has seen about a 20 percent increase in chlamydia cases during the past six months. But that may be because more males are willing to be screened than in the past, she added.