Which population does the USPSTF recommend chlamydia screening for?

• A. Screen all sexually active women 24 years or younger and older women at increased risk
• B. Screen all sexually active women regardless of age
• C. Screen all sexually active women 24 years or younger and 25 years or older at increased risk
• D. Do not screen for chlamydia

Answer: (C)

The concept being tested is which populations USPSTF recommends for chlamydia screening. USPSTF advises screening all sexually active women who are 24 years old or younger, and for women who are 25 years or older only if they are at increased risk (for example, having new or multiple sex partners, inconsistent condom use, or a history of sexually transmitted infections). This risk-based approach targets groups with higher prevalence and potential complications, making screening more effective and cost-efficient.

Screening all sexually active women regardless of age is not recommended, because the benefit is much smaller in older, lower-prevalence populations and resources would be used without as much payoff. Do not screen at all is not correct, since the guideline supports screening in the specified groups. The option that matches the USPSTF recommendation—screen all sexually active women 24 years or younger and those 25 years or older at increased risk—best captures the intended, age- and risk-based strategy.