Task Force Recommends Against Screening for Chronic Obstructive Pulmonary Disease...

Task Force Recommends Against Screening for Chronic Obstructive Pulmonary
Disease Using Spirometry

ROCKVILLE, Md., March 3 /PRNewswire-USNewswire/ -- Adults without symptoms of
chronic obstructive pulmonary disease (COPD) should not be screened for the
disease using spirometry, according to a new recommendation from the U.S.
Preventive Services Task Force. The recommendation and the accompanying
summary of evidence are posted online in the Annals of Internal Medicine. It
will appear in the April 1, 2008, print edition of the journal.

COPD is a lung disease in which the airways in the lungs are damaged, making
it hard to breathe. COPD is the fourth leading cause of death and affects
more than 5 percent of the U.S. population. Current or past cigarette smoking
is the most common cause of COPD. Breathing in chemicals or other kinds of
lung irritants over a long period of time may also cause or contribute to
COPD, and individuals over the age of 40 are also at higher risk for the
disease.

Screening for COPD is most often performed using spirometry, a lung function
test that uses a spirometer machine. Spirometry is performed by having a
patient breathe into a tube attached to a spirometer machine, which calculates
the amount of air the lungs can hold and the rate that air can be inhaled and
exhaled. The results of the test are compared with those of healthy
individuals of similar height and age and of the same gender and race.

The Task Force found that the benefits of screening individuals without
symptoms of COPD were very small. Approximately 400 adults between the ages
of 60-69 would need to be screened in order to identify a single patient who
may later develop COPD symptoms severe enough to require immediate medical
care. The Task Force also found that spirometry can substantially overdiagnose
COPD in people over the age of 70 who have never smoked and can produce some
false positives in younger adults.

In those patients experiencing symptoms of COPD, including coughing that
doesn't go away, coughing up large amounts of mucus, shortness of breath,
wheezing and chest tightness, spirometry may be used to confirm a diagnosis of
COPD. The Task Force found evidence that the diagnosis did not have an impact
on the number of patients who quit smoking, nor could they find evidence that
it increased the number of patients who received the flu vaccine. Quitting
smoking is the single most important thing a patient can do to slow the
progression of the disease, and there is some evidence that getting vaccinated
against the flu can prevent worsening of COPD symptoms.

"Our review of the evidence found that screening for COPD with spirometry in
patients who report no symptoms provides very little or no benefit to
individuals, even in those who are eventually diagnosed with the disease,"
said Task Force Chair Ned Calonge, M.D., who is also Chief Medical Officer for
the Colorado Department of Public Health and Environment. "We encourage
clinicians to focus on screening all adults for tobacco use and helping
individuals who smoke to choose evidence-based therapies that can help them to
quit."

The Task Force is the leading independent panel of experts in prevention and
primary care. The Task Force, which is supported by AHRQ, conducts rigorous,
impartial assessments of the scientific evidence for the effectiveness of a
broad range of clinical preventive services, including screening, counseling,
and preventive medications. Its recommendations are considered the gold
standard for clinical preventive services. The Task Force recommends against
screening adults for COPD using spirometry. (D recommendation)

The recommendations and materials for clinicians are available on the AHRQ Web
site here. Previous Task Force
recommendations, summaries of the evidence, and related materials are
available from the AHRQ Publications Clearinghouse by calling (800) 358-9295
or sending an e-mail to ahrqpubs@ahrq.gov. Clinical information is also
available from AHRQ's National Guideline Clearinghouse at
www.guideline.gov.

AHRQ Public Affairs
(301) 427-1246
(301) 427-1258

SOURCE Agency for Healthcare Research & Quality

Agency for Healthcare Research & Quality, +1-301-427-1246 or +1-301-427-1258