Detection of COPD in smokers

摘要: Smoking is the main risk factor for Chronic Obstructive Pulmonary Disease (COPD), formerly known as lung emphysema or ‘chronic bronchitis’. Early detection of COPD and smoking cessation may result in significant health gain. In a thesis titled ‘Detection smokers’ results 6 studies middle-aged male smokers, conducted between 1998 2003 IJsselstein, town center The Netherlands, are presented. At baseline survey, among 702 mean age 50 years, prevalence previously undetected defined according to GOLD criteria was high (30%). Smokers with disease predominantly experienced mild airflow obstruction (87%). multivariate regression analysis only cough were independently related presence COPD. ability these determinants discriminate subjects without from those relatively poor (ROC area 0.65). 2003, 33 399 participants developed moderate COPD, i.e. cumulative incidence 8.3%. Notably, limitations physical functioning measured by MRC dyspnoea scale correlated more strongly quality life than severity staging. developing smokers 5 times higher normal spirometry (1 vs. 1 25). Age, cough, before 16 ? recent GP consultations because lower respiratory tract (LRT) complaints associated development A prediction rule, based on 4 patients characteristics, showed reasonable discriminative 0.72). Taking cut-off 2 points would identify much 79% (26/33) actually next years 52% not Among 45-64 age, nationwide screening Netherlands expected offer approximately 195,000 newly detected cases one year case finding general practice over 78,000 new cases. Screening however less favorable balance costs effects finding. cost-effectiveness intensive therapy – per subject who remained abstinent during at least - markedly short therapy. Main recommendations: Intensifying interventions targeted (55-64 symptoms) physician diagnosed should be encouraged. can recommended. Case seems an attractive alternative, provided that logistically possible drug treatment nicotine addiction reimbursed. Health care resources preferably applied facilitate additional measures prevent uptake encourage population large rather develop programs ‘healthy’ smokers.