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The UK National Institute for Health and Clinical Excellence (NICE) public health guidance on interventions for the prevention of STI and under-18 conceptions1 follows consultation and the commission of three reviews, including a rapid review of the evidence for the effectiveness of screening for genital chlamydia infection in sexually active men and women.2 This review found evidence from two randomised trials that register-based screening (where eligible individuals are identified from a population register, such as a general practice list, and invited to undergo screening) could reduce the incidence of pelvic inflammatory disease (PID) by about half at 1 year. However, the review found no trials of the effectiveness of opportunistic screening (where screening is offered to eligible individuals attending healthcare settings for any reason) which is the main approach of the National Chlamydia Screening Programme (NCSP) in England.
Competing interests: I am co-author of a NICE-commissioned review of chlamydia screening and have tried unsuccessfully to get funding for a large trial of chlamydia screening.