More than 100,000 persons in the United States die each year as a result of chronic obstructive pulmonary disease (COPD), making it the fourth leading cause of death. Despite declining trends in mortality rates for cardiovascular disease, the mortality rate for COPD is rising. COPD is usually diagnosed late in the disease process, when patients are more likely to have advanced disease. Earlier detection of COPD would allow treatment before patients reach the symptomatic stage. Zieliñski and colleagues evaluated the effectiveness of mass spirometry screening in the detection of airflow obstruction, the principal sign of COPD, in a high-risk population.
Free spirometry was offered to smokers who were at least 40 years of age and had a smoking history of more than 10 pack-years. Before the study, mass media information on the signs and symptoms of COPD was disseminated in 12 large cities in Poland. A total of 11,027 persons with a mean age of 58.1 years participated in the study. Fifty-seven percent were men, and 80 percent were current or former smokers, with an average smoking history of 26 pack-years.
Spirometric signs of airway obstruction were found in 24.3 percent of participants. Mild to moderate obstruction was found in approximately 19 percent of subjects, while 5 percent had severe obstruction. In smokers 40 years or older who had a smoking history of at least 10 pack-years, airway obstruction was found in 30.6 percent.
The authors conclude that mass spirometry in patients 40 years and older with more than a 10 pack-year smoking history can uncover a significant number of persons with spirometric signs of airway obstruction. Early detection of COPD could allow for earlier interventions and provide motivation for smoking cessation.