USPSTF reiterates syphilis screening for at-risk teens, adults
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The U.S. Preventive Services Task Force has issued a draft recommendation that encourages health care professionals to screen asymptomatic adolescents and adults who are at increased risk for syphilis.
The task force’s grade “A” draft recommendation comes amid CDC data demonstrating a recent surge in sexually transmitted infections, including syphilis, in the U.S.
“Clinicians play an important role in helping to lower the rising rates of syphilis infection and keeping at‐risk patients healthy,” Katrina Donahue, MD, MPH, a task force member and professor and vice chair of research at the University of North Carolina at Chapel Hill, said in a press release.
The draft recommendation is consistent with the USPSTF’s 2016 final recommendation in this clinical area, according to the task force. The 2016 recommendation has the support of the American Academy of Family Physicians; however, the American College of Obstetricians and Gynecologists does not endorse routine syphilis screening in women who are not pregnant, according to an evidence review.
Health care professionals should consider the rate of syphilis in their area and patients’ individual risk when deciding who to screen for the infection, according to the USPSTF. Syphilis occurs more frequently among men who have sex with men; people living with HIV; those who are in prison or were imprisoned; those who have a history of sex work; and those who have served in the military, the task force said. In addition, adolescents and adults from underrepresented populations are at increased risk for syphilis compared with white adolescents and adults, the USPSTF said in a press release.
Comments on the new draft recommendation are being accepted until March 14 at www.uspreventiveservicestaskforce.org/tfcomment.htm.
References:
Screening for syphilis infection in nonpregnant adolescents and adults: A targeted evidence update for the U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/uspstf/syphilis-infection-screening-draft-evidence-review. Published Feb. 15, 2022. Accessed Feb. 15, 2022.
Screening for syphilis infection in nonpregnant adolescents and adults: U.S. Preventive Services Task Force draft reaffirmation recommendation statement. https://www.uspreventiveservicestaskforce.org/uspstf/syphilis-infection-screening-draft-recommendation-statement-questionnaire, Published Feb. 15, 2022. Accessed Feb. 15, 2022.
U.S. Preventive Services Task Force issues draft recommendation on screening for syphilis infection. https://www.uspreventiveservicestaskforce.org/uspstf/draft-update-summary/syphilis-infection-nonpregnant-adults-adolescents-1. Published Feb. 15, 2022. Accessed Feb. 15, 2022.
Perspective
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Jeffrey D. Klausner, MD, MPH
Unfortunately, there have been steady increases in syphilis in the United States for more than a decade, with rates rising among all sexually active adults. One major concern has been the increase in pregnant women, resulting in an unprecedented number of cases of congenital syphilis.
The USPSTF recommendations provide important reaffirmation of the benefit of routine syphilis screening in sexually active adults. A level “A” recommendation indicates that syphilis screening should be offered as a preventive service, without co-pay, and be offered in all primary care medical settings. Furthermore, routine syphilis screening should be used as a quality indicator for primary care medical practice. Third-party insurers, both private and public, should share with covered beneficiaries the syphilis testing performance of their contracted primary care medical providers.
We and others have shown that more frequent syphilis screening can increase the early identification of cases and result in decreased community transmission. It is incumbent among infectious disease providers and other internists to educate our colleagues, promote syphilis screening and work with others to assure quality preventive care.
Keck School of Medicine, University of Southern California
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