Screening For COPD in Asymptomatic Adults Not Recommended by USPSTF

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by Marta Silva |

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Chronic Obstructive Pulmonary Disease (COPD) includes a group of progressive lung diseases such as emphysema, chronic bronchitis, non-reversible asthma, and some forms of bronchiectasis. COPD typically manifests itself in individuals who have had a long-term contact with harmful pollutants,a history of smoking, or who have a genetic predisposition to the disease. According to the COPD Foundation, the disease affects over 24 million Americans, and some of its symptoms are often confused with aging, such as increased breathlessness or coughing.
In response to this, the U.S. Preventive Services Task Force (USPSTF) is preparing a recommendation statement noting that screening for COPD in asymptomatic adults is not recommended since it is not seen as a prognostic tool that is able to improve Americans’ life quality in the long run.
The USPSTF is composed of an independent panel of American experts in prevention and evidence-based medicine. The 2015 draft that is now being discussed regarding COPD screening is in agreement with the USPTSF screening recommendations of 2008 for COPD, in which the use of the technique spirometry to test COPD in adults was discouraged. Spirometry is a simple test in which a patient blows all the air out of the lungs into a mouthpiece connected to the spirometer. The spirometer calculates the amount of air blown in the first (t=1s) and sixth (t=6s) seconds. The ratio of air between second 1 and second 6 is usually less than 70% in COPD patients.
When questioned about the 2015 draft, William Phillips, MD, MPH member of the USPSTF, explained that there seems to be no evidence that screening asymptomatic adults will improve overall health conditions. On top of this, the investment of screening asymptomatic adults could be too great to support. Moreover, data showed that COPD screenings prior to the development of symptoms did not influence treatment decisions, mortality nor morbidity rates. Mr Phillips reinforced that the best COPD prevention is in fact to avoid smoking.

The public opinion is invited to discuss the recomendation until the 14th of September 2015, the day in which the final version will be published. It is also worth noting that that institutions like the American College of Physicians and the National Institute for Health and Clinical Excellence support the draft presented by the USPSTF.