Kirsten Bibbins-Domingo1, David C Grossman2, Susan J Curry3, Karina W Davidson4, John W Epling5, Francisco A R García6, Matthew W Gillman7, Diane M Harper8, Alex R Kemper9, Alex H Krist10, Ann E Kurth11, C Seth Landefeld12, Carol M Mangione13, William R Phillips14, Maureen G Phipps15, Michael P Pignone16. 1. University of California, San Francisco. 2. Group Health Research Institute, Seattle, Washington. 3. University of Iowa, Iowa City. 4. Columbia University, Manhattan, New York. 5. State University of New York Upstate Medical University, Syracuse. 6. Pima County Department of Health, Tucson, Arizona. 7. Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts. 8. University of Louisville, Louisville, Kentucky. 9. Duke University, Durham, North Carolina. 10. Fairfax Family Practice, Fairfax, Virginia11Virginia Commonwealth University, Richmond. 11. Yale University, New Haven, Connecticut. 12. University of Alabama at Birmingham. 13. University of California, Los Angeles. 14. University of Washington, Seattle. 15. Brown University, Providence, Rhode Island. 16. University of North Carolina, Chapel Hill.
Abstract
IMPORTANCE: In 2014, 19,999 cases of syphilis were reported in the United States. Left untreated, syphilis can progress to late-stage disease in about 15% of persons who are infected. Late-stage syphilis can lead to development of inflammatory lesions throughout the body, which can lead to cardiovascular or organ dysfunction. Syphilis infection also increases the risk for acquiring or transmitting HIV infection. OBJECTIVE: To update the 2004 US Preventive Services Task Force (USPSTF) recommendation on screening for syphilis infection in nonpregnant adults. Screening for syphilis in pregnant women was updated in a separate recommendation statement in 2009 (A recommendation). EVIDENCE REVIEW: The USPSTF reviewed the evidence on screening for syphilis infection in asymptomatic, nonpregnant adults and adolescents, including patients coinfected with other sexually transmitted infections (such as HIV). FINDINGS: The USPSTF found convincing evidence that screening for syphilis infection in asymptomatic, nonpregnant persons at increased risk for infection provides substantial benefit. Accurate screening tests are available to identify syphilis infection in populations at increased risk. Effective treatment with antibiotics can prevent progression to late-stage disease, with small associated harms, providing an overall substantial health benefit. CONCLUSIONS AND RECOMMENDATION: The USPSTF recommends screening for syphilis infection in persons who are at increased risk for infection. (A recommendation).
IMPORTANCE: In 2014, 19,999 cases of syphilis were reported in the United States. Left untreated, syphilis can progress to late-stage disease in about 15% of persons who are infected. Late-stage syphilis can lead to development of inflammatory lesions throughout the body, which can lead to cardiovascular or organ dysfunction. Syphilis infection also increases the risk for acquiring or transmitting HIV infection. OBJECTIVE: To update the 2004 US Preventive Services Task Force (USPSTF) recommendation on screening for syphilis infection in nonpregnant adults. Screening for syphilis in pregnant women was updated in a separate recommendation statement in 2009 (A recommendation). EVIDENCE REVIEW: The USPSTF reviewed the evidence on screening for syphilis infection in asymptomatic, nonpregnant adults and adolescents, including patients coinfected with other sexually transmitted infections (such as HIV). FINDINGS: The USPSTF found convincing evidence that screening for syphilis infection in asymptomatic, nonpregnant persons at increased risk for infection provides substantial benefit. Accurate screening tests are available to identify syphilis infection in populations at increased risk. Effective treatment with antibiotics can prevent progression to late-stage disease, with small associated harms, providing an overall substantial health benefit. CONCLUSIONS AND RECOMMENDATION: The USPSTF recommends screening for syphilis infection in persons who are at increased risk for infection. (A recommendation).
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