This method is endorsed by the U.S. Centers for Disease Control and Prevention (CDC) and is the standard in many parts of the world.

After screening for syphilis, a titer can be used to track the progress of the disease over time and its response to therapy.

Tests based on monoclonal antibodies and immunofluorescence, including T. pallidum hemagglutination assay (TPHA) and fluorescent treponemal antibody absorption (FTA-ABS) are more specific and more expensive.

Nontreponemal tests (NTT) measure levels of immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies produced by the host in response to lipoidal material (mostly cardiolipin) released from damaged host cells.

It has been recommended that a careful explanation of this fact be included with test results.