Combined screening could boost COPD detection

Sep 6 2013

Researchers from Japan say that the detection of chronic obstructive pulmonary disease (COPD) could be enhanced by incorporating screening into existing lung cancer screening programs.

“COPD is substantially underdiagnosed and frequently misdiagnosed,” comments the team in Respirology.

They add: “However, although pulmonary function testing (PFT) has been well recognized as an appropriate tool for detecting COPD, effective methods for early detection of COPD have not been identified.”

They examined data on COPD screening, involving questions on smoking status and chronic respiratory symptoms, in patients aged over 60 years, which was introduced into an existing lung cancer screening program for the over 40s in Chiba City in 2008.

Between April 2010 and March 2011, 72,653 residents aged at least 60 years took part in the program, of whom 878 (1.0%) were suspected to have COPD and referred for secondary examination. In all, 369 residents underwent PFT and 480 underwent computed tomography to detect emphysema.

This resulted in a diagnosis of COPD/emphysema among 161 residents, a detection rate of 0.18% from the initial screening population of 89,100. Overall, 47 (46.1%) of diagnosed residents required treatment.

“Screening for COPD can be performed on a large population with minimal additional expense because it can be added to an already established screening system for lung cancer,” says the team, led by Yasuo Sekine (Tokyo Women’s Medical University Yachiyo Medical Center).

They note that when the additional screening was first introduced, rates of referral to secondary evaluation centers were low but increased in the following years, which they suggest was due to increased physician awareness.

“The rate of detection can be increased by educating general practitioners on the importance of COPD screening,” the authors write.

“The cost effectiveness, risks of this screening system, and the appropriateness of the current COPD criteria need further evaluation,” they conclude.

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