Chronic obstructive pulmonary disease (COPD)

There are no data to show conclusively that screening spirometry is effective in directing management decisions or in improving COPD outcomes in asymptomatic patients, and the US Preventive Services Task Force (USPSTF) recommends against screening in this population.[74]US Preventive Services Task Force. Final recommendation statement: chronic obstructive pulmonary disease: screening. May 2022 [internet publication]. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/chronic-obstructive-pulmonary-disease-screening However, if COPD is diagnosed at an early stage and risk factors are eliminated, the rate of decline in lung function will dramatically decrease.[75]Welte T, Vogelmeier C, Papi A. COPD: early diagnosis and treatment to slow disease progression. Int J Clin Pract. 2015 Mar;69(3):336-49. https://onlinelibrary.wiley.com/doi/10.1111/ijcp.12522 http://www.ncbi.nlm.nih.gov/pubmed/25363328?tool=bestpractice.com  

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines advocate early case-finding by performing spirometry in patients with symptoms and/or risk factors for COPD.[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2024 report. 2024 [internet publication]. https://goldcopd.org/2024-gold-report UK guidelines advise spirometry in all patients ages 35 years or older who are current or former smokers and have a chronic cough, to detect cases at an early stage. Clinicians should also consider conducting screening spirometry in all patients with findings compatible with emphysema on chest x-ray or computed tomography of the chest.[2]National Institute for Health and Care Excellence. Chronic obstructive pulmonary disease in over 16s: diagnosis and management. Jul 2019 [internet publication]. https://www.nice.org.uk/guidance/ng115 Significant pulmonary dysfunction may be present in asymptomatic smokers.