There are no data to show conclusively that screening spirometry is effective in directing management decisions or in improving COPD outcomes in asymptomatic patients. However, if COPD is diagnosed at an early stage and risk factors are eliminated, the rate of decline in lung function will dramatically decrease.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines advocate active case-finding by performing spirometry in patients with symptoms and/or risk factors for COPD. 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. Significant pulmonary dysfunction may be present in asymptomatic smokers.
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