Are you a smoker? Does it benefit you to get a screening test for COPD?

Are you a smoker? Does it benefit you to get a screening test for COPD?

Last Reviewed : 12/30/2020
Are you a smoker? Does it benefit you to get a screening test for COPD?

If you are a smoker, you should have come across Chronic Obstructive Pulmonary Disease (COPD). But then, we cannot completely rule out the fact that you haven’t stumbled across it even as a heavy smoker. Either way, this informative guide aims to help you understand the appropriate condition for the test. With that being said, we will kick off this guide by walking you through all there is to know about the disease.



About COPD

COPD is defined as an irreversible limitation of airways, which is associated with abnormal inflammatory response of airways to any harmful particles or gases. According to experts, it is the third-leading cause of death in the United States, and almost 14% of individuals aged 40-79 have it. The patients often have a history of chronic smoking, exposure to chemicals, specks of dust, and heating fuels. Also, patients with severe COPD are not able to perform normal physical activity due to deteriorating of lung functions. Symptoms of COPD include difficulty breathing and chronic cough with sputum production. Diagnosis of COPD depends on spirometry, where a ratio of FEV1/FVC less than 0.7 is the current criterion to make the definitive diagnosis.

Exposures to chronic cigarette smoking, dust, fumes, toxins, and chemicals increase the risk of COPD in an individual. About 15%-50% of smokers develop COPD later in their life, and almost 70% of COPD cases are current or former smokers. Studies also show that 15% of all COPD cases are due to occupational exposures to chemicals, dust, and harmful toxins. Traffic pollution and wood fumes are also associated with increased risk. Other risk factors include a history of asthma, childhood infections, and a1- antitrypsin deficiency. As the majority of COPD cases are due to chronic smoking exposure and other chemical toxins, the most effective treatment to prevent COPD is to avoid and limit such exposures.



COPD Screening

Well, the screening of COPD in adults follows an algorithm where the first risk assessment is done via a prescreening questionnaire . Afterward, it is followed by screening spirometry and then diagnostic spirometry. Screening spirometry is a spirometry without a bronchodilator response, and diagnostic spirometry is positive when airway obstruction is present even after the administration of a bronchodilator. Albuterol is the bronchodilator used to dilate airways in spirometry. COPD is diagnosed when the post-bronchodilator FEV1/FVC ratio is less than 0.7. However, severity depends on the percentage of predicted post-bronchodilator FEV1. Mid COPD is 80% or more, moderate is 50%-79%, severe is 30%-49%, and less than 30% is very severe COPD.

The U.S. Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific screening of disease in individuals with risk factors and no related signs and symptoms based on the balance between harm and benefits of the screening. The USPSTF did not find any study that assessed the effectiveness of the screening of COPD in asymptomatic patients. Instead, the harm of the prescreening questionnaire and screening spirometry is high false-negative and false-positive results.



Final Notes

In conclusion, the USPSTF found no adequate evidence that screening for COPD in asymptomatic individuals with spirometry and questionnaire improves clinical outcomes. Early screening of COPD in asymptomatic people does not alter the course of the disease or its outcome. The USPSTF found inadequate evidence on the harms of the screening. The Task Force does not recommend screening of COPD in individuals with no symptoms of COPD.

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