U.S. Preventive Services Task Force

Screening for Chronic Obstructive Pulmonary Disease: Recommendation Statement

 


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Am Fam Physician. 2016 Jul 15;94(2):online.

Summary of Recommendation and Evidence

The USPSTF recommends against screening for chronic obstructive pulmonary disease (COPD) in asymptomatic adults (Table 1). D recommendation.

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Table 1.

Screening for Chronic Obstructive Pulmonary Disease: Clinical Summary of the USPSTF Recommendation

Population

Asymptomatic adults who do not present with respiratory symptoms

Recommendation

Do not screen for COPD.

Grade: D

Risk assessment

Risk factors include history of exposure to cigarette smoke or heating fuels; occupational exposure to toxins, dusts, or industrial chemicals; exposure to environmental pollution, such as wood smoke and traffic pollutants; history of asthma or childhood respiratory tract infections; and α1-antitrypsin deficiency.

Screening tests

Primary care screening involves either risk assessment via a formal prescreening questionnaire and, if positive, follow-up with diagnostic spirometry testing or screening spirometry administered without a bronchodilator and, if positive, follow-up with diagnostic spirometry testing.

Treatment and interventions

Medications used to treat COPD include long-acting β-agonists, inhaled corticosteroids, long-acting anticholinergics, and combination therapy with corticosteroids and long-acting β-agonists.

Balance of benefits and harms

The USPSTF concludes with moderate certainty that screening for COPD in asymptomatic persons has no net benefit.

Other relevant USPSTF recommendations

The USPSTF recommends that clinicians ask all adults about tobacco use, including pregnant women, and provide tobacco cessation interventions for those who use tobacco products. The USPSTF also recommends that clinicians provide interventions, including education or brief counseling, to prevent initiation of tobacco use in school-aged children and adolescents. These recommendations are available on the USPSTF website ( http://www.uspreventiveservicestaskforce.org).


note: For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, go to http://www.uspreventiveservicestaskforce.org/.

COPD = chronic obstructive pulmonary disease; USPSTF = U.S. Preventive Services Task Force.

Table 1.

Screening for Chronic Obstructive Pulmonary Disease: Clinical Summary of the USPSTF Recommendation

Population

Asymptomatic adults who do not present with respiratory symptoms

Recommendation

Do not screen for COPD.

Grade: D

Risk assessment

Risk factors include history of exposure to cigarette smoke or heating fuels; occupational exposure to toxins, dusts, or industrial chemicals; exposure to environmental pollution, such as wood smoke and traffic pollutants; history of asthma or childhood respiratory tract infections; and α1-antitrypsin deficiency.

Screening tests

Primary care screening involves either risk assessment via a formal prescreening questionnaire and, if positive, follow-up with diagnostic spirometry testing or screening spirometry administered without a bronchodilator and, if positive, follow-up with diagnostic spirometry testing.

Treatment and interventions

Medications used to treat COPD include long-acting β-agonists, inhaled corticosteroids, long-acting anticholinergics, and combination therapy with corticosteroids and long-acting β-agonists.

Balance of benefits and harms

The USPSTF concludes with moderate certainty that screening for COPD in asymptomatic persons has no net benefit.

Other relevant USPSTF recommendations

The USPSTF recommends that clinicians ask all adults about tobacco use, including pregnant women, and provide tobacco cessation interventions for those who use tobacco products. The USPSTF also recommends that clinicians provide interventions,


This recommendation statement was first published in JAMA. 2016;315(13):1372–1377.

The “Other Considerations,” “Discussion,” “Update of Previous USPSTF Recommendation,” and “Recommendations of Others” sections of this recommendation statement are available at http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/chronic-obstructive-pulmonary-disease-screening.

The USPSTF recommendations are independent of the U.S. government. They do not represent the views of the Agency for Healthcare Research and Quality, the U.S. Department of Health and Human Services, or the U.S. Public Health Service.

REFERENCES

1. Kochanek KD, Murphy SL, Xu J, Arias E. Mortality in the United States, 2013. NCHS Data Brief. 2014;(178):1–8.

2. Tilert T, Dillon C, Paulose-Ram R, Hnizdo E, Doney B. Estimating the U.S. prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry: the National Health and Nutrition Examination Survey (NHANES) 2007–2010. Respir Res. 2013;14:103.

3. Guirguis-Blake JM, Senger CA, Webber EM, Mularski RA, Whitlock EP. Screening for chronic obstructive pulmonary disease: a systematic evidence review for the U.S. Preventive Services Task Force. Evidence synthesis no. 130. AHRQ publication no. 14-05205-EF-1. Rockville, Md.: Agency for Healthcare Research and Quality; 2016.

As published by the U.S. Preventive Services Task Force.

This summary is one in a series excerpted from the Recommendation Statements released by the USPSTF. These statements address preventive health services for use in primary care clinical settings, including screening tests, counseling, and preventive medications.

The complete version of this statement, including supporting scientific evidence, evidence tables, grading system, members of the USPSTF at the time this recommendation was finalized, and references, is available on the USPSTF website at http://www.uspreventiveservicestaskforce.org/.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of USPSTF recommendation statements published in AFP is available at http://www.aafp.org/afp/uspstf.



 

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