USPSTF Draft Recommendation: Screen Higher-Risk Patients for Syphilis

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Nonpregnant adolescents and adults who are at increased risk for syphilis should be screened for the infection, according to a draft recommendation statement issued Monday by the U.S. Preventive Services Task Force. The grade A recommendation complements the group's 2009 recommendation to screen all pregnant women for syphilis.

The two main groups at increased risk are men who have sex with men and HIV-infected patients, the USPSTF says. However, it notes, "When deciding who to screen ... clinicians should also consider other sociodemographic factors that are associated with increased prevalence rates, including male sex combined with age younger than 29 years, race/ethnicity, geography, incarceration, and sex work." In particular, syphilis is more prevalent in southern and western states, in metropolitan areas, and among blacks.

The task force says it found "convincing evidence" of the benefits of early detection and treatment — and no "direct evidence" of harms from screening — among at-risk groups.

The draft recommendation is open for public comment until January 18, 2016 at the link below.