New study shows rise in undiagnosed chlamydia cases in Ontario
By: Anna O’Brien
A recent study published in the Annals of Family Medicine found that changes to Ontario’s cervical-cancer screening guidelines have led to thousands of women not being tested and diagnosed for chlamydia.
With most chlamydia infections detected through pap testing, the new protocol is causing many cases to be missed. Recent cervical-cancer screenings guidelines recommend screening less frequently and starting later.
The provincial guidelines adopted 2012 recommends sexually active women should undergo a pap test every three years starting at age 21, as opposed to previous protocols suggesting one performed annually starting three years after becoming sexually active.
Chlamydia testing dropped 26 per cent in females aged between 15 to 19 and 18 per cent in those aged 20 to 24 after the changes to the guidelines, the study published in the July 10 issue showed. This has led to more than 2,700 fewer cases being detected, according to the study’s authors Allison Ursu, Ananda Sen and Mack Ruffin.
Dr. Rita Shahin, Toronto’s Associate Medical Officer of Health, says chlamydia is so common because it often remains symptomless.
“Untreated chlamydia can live in the body for months or even years,” Shanin said. “This leads to a greater likelihood that those infected will spread the disease to others.”
In an attempt to decrease the spread of infection, Toronto Public Health created a social media campaign called CondomTO to emphasize the “importance of condom use, combat sexual shame and stigma, and normalize safe sex behaviour.”
Both Pap and chlamydia tests are available under Ontario’s health plan through physician offices, hospitals, public health departments, post-secondary health services, and community health centers.
As the most common sexually transmitted infection (STI), chlamydia, if left untreated, can lead to pelvic inflammatory disease, ectopic pregnancy and infertility.
Nadine Chidley, a 26-year-old master of professional communication student at Ryerson University, has been getting regular pap tests since she was 21. Chidley knows a lot of women who have yet to get tested since the guidelines changed in 2012.
“Honestly, if my doctor didn’t constantly remind me, I probably would not go out of my way to get a pap test done,” Chidley said. “It’s so important that women get regularly checked, but I understand opting out now that the guidelines don’t force it on them annually. They’re uncomfortable and I can’t blame them.”
Dr. Sarah Ferguson, a gynecologist at the Bay Centre for Birth Control Clinic in Toronto, stressed the importance of getting tested to limit the spread of infection.
“This is particularly worrying for sexually active women between the ages of 15 to 21,” Ferguson said. “If you’re engaging in sexual activity, you should be tested, period.
“Once every three years after the age of 21 is just not enough,” she said.
The Bay Centre for Birth Control has developed a weekly drop-in pap program available to any woman seeking a pap test. The program runs on Wednesday evenings between 4 p.m. and 7 p.m.