March 14, 2022
National Center for Health Research’s Comments on U.S. Preventive Services Task Force’s Draft Recommendation on Screening for Syphilis Infection in Nonpregnant Adolescents and Adults
We are writing to express our views on the U.S. Preventive Services Task Force’s (USPSTF) draft recommendation statement regarding screening for syphilis infection in asymptomatic, nonpregnant adolescents and adults who are at increased risk for syphilis infection.
The National Center for Health Research (NCHR) is a nonprofit think tank that conducts, analyzes, and scrutinizes research on a range of health issues, with particular focus on which prevention strategies and treatments are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.
We support the reaffirmation of the previous “A” recommendation of syphilis screening in persons who are at increased risk for infection. Syphilis cases have been increasing in the last 20 years, and we agree with the USPSTF that there is a substantial net benefit to screening in asymptomatic individuals, especially since there are known benefits that early detection can stop the progression of the disease.
We appreciate the recommendation that healthcare providers make an assessment of which patients are at high risk based on the latest local data, through methods such as consulting the CDC database linked in the recommendation. However, we urge USPSTF to provide as much guidance as possible to ensure that healthcare providers do not base their decisions on personal or widely held stereotypes pertaining to age, race, ethnicity, social class, or appearance. We agree with the review that there is a need for further research in order to assist healthcare providers in making an unbiased assessment of who is high-risk. For example, healthcare providers in a primary care setting would benefit from validated tools that assess who is at highest risk. A validated scale that objectively measures patients’ risk levels reduces the likelihood of providers conducting screening based on stereotypes or bias rather than data. In addition, research is needed to identify the ideal intervals for screening for each high-risk population.
The National Center for Health Research can be reached at info@center4research.org or at (202) 223-4000.