There are no data to show conclusively that screening spirometry is effective in directing management decisions or in improving COPD outcomes in patients who are identified before the development of significant symptoms. However, if COPD is diagnosed at an early stage and risk factors are eliminated, the rate of decline in lung function will dramatically decrease. Treatment is much more efficacious in the early stages of disease.
Screening can be done by asking about smoking history and environmental or occupational exposure. In high-risk populations a screening spirometry should be obtained to document airway obstruction. Some experts advocate 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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