Task Force Recommends Against COPD Screening of Asymptomatic Adults
Chronic Obstructive Pulmonary Disease is a term for progressive lung diseases such as emphysema, chronic bronchitis, and in some cases asthma. It affects an estimated 24 million Americans, according to the COPD Foundation. CDC reported COPD was the third-leading cause of death in the United States in 2011.
The U.S. Preventive Services Task Force has updated its 2008 recommendation on screening for COPD in asymptomatic adults. After reviewing the evidence on whether screening for COPD in adults who do not recognize or report respiratory symptoms improves their health outcomes, the task force did not find evidence that the screening improves health-related quality of life, morbidity, or mortality; and that detection of COPD before the development of symptoms does not alter the course of the disease or improve patient outcomes. The panel concluded with moderate certainty that screening for COPD in asymptomatic persons has no net benefit, according to recommendations published April 5 in JAMA.
Chronic Obstructive Pulmonary Disease is a term for progressive lung diseases such as emphysema, chronic bronchitis, and in some cases asthma. It affects an estimated 24 million Americans, according to the COPD Foundation. CDC reported COPD was the third-leading cause of death in the United States in 2011.
The task force reviewed the diagnostic accuracy of screening tools (including prescreening questionnaires and spirometry); whether screening for COPD improves the delivery and use of targeted preventive services such as smoking cessation or immunizations; and the possible harms of screening for and treatment of mild to moderate COPD -- but not the cost of providing services -- before recommending against screening for COPD in asymptomatic adults.
About 14 percent of U.S. adults ages 40-79 have COPD, which is defined as airflow limitation that is not fully reversible.
Exposure to cigarette smoke or toxic fumes increases the risk for COPD. Epidemiological studies have found that 15-50 percent of smokers develop COPD, while occupational exposures to toxins, dusts, and industrial chemicals causes an estimated 15 percent of all COPD cases.
The task force also recommends that clinicians ask all adults, including pregnant women, about tobacco use and provide tobacco cessation interventions for those who use tobacco products.