CHEST
Volume 119, Issue 3, March 2001, Pages 731-736
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Clinical Investigations
Early Detection of COPD in a High-Risk Population Using Spirometric Screening

https://doi.org/10.1378/chest.119.3.731Get rights and content

Study objectives:

To evaluate the efficacy of massspirometry use for the detection of airflow obstruction in a high-riskpopulation.

Design:

Free spirometry was of fered tosmokers who were > 39 years of age with a smoking history of > 10pack-years. Action was preceded by the dissemination of information onthe causes and symptoms of COPD in the local mass media.

Settings:

Pulmonary outpatient clinics in 12 large cities of Poland.

Participants:

Eleven thousand twenty-sevensubjects with the following characteristics were screened: mean(± SD) age, 51.8 ± 12.5 years; men, 57%; current or ex-smokers,80%; and mean smoking history, 26.1 ± 16.8 pack-years.

Interventions:

Smoking history, simple spirometry (FVC and FEV1), and an antismoking advice.

Results:

Spirometric signs of airway obstruction were found in 24.3% of thesubjects who were screened. Of those subjects, mild obstruction wasfound in 9.5%, moderate obstruction was found in 9.6%, and severeobstruction was found in 5.2%. In smokers aged ≥ 40 years who had asmoking history of > 10 pack-years, airway obstruction was found in30.6%. Airway obstruction was present in 8.3% of smokers < 40 yearsof age who had a smoking history of < 10 pack-years. Of the 2,200subjects who had never smoked in their lives, airway obstruction wasfound in 14.4%.

Conclusions:

Mass spirometryin high-risk groups is an effective and easy method for the earlydetection of COPD.

Section snippets

Materials and Methods

Pulmonary physicians, members of the Know the Age of Your LungStudy Group, performed their investigations in pulmonary outpatientclinics in 12 Polish cities. They prepared written materials for localTV, radio, or newspapers. Materials included information on the causesand symptoms of COPD. In some places, it was thought that the termCOPD was unfamiliar, and it was replaced by the better knownterm emphysema. Information that not all smokers aresusceptible to COPD and that spirometry is a simple

Results

A total number of 11,027 evaluable spirograms and questionnaireswere reviewed. Subjects consisted of 57.3% men and 42.7% women, with a mean (± SD) age of 51.8 ± 12.5 years. Eighty percent of subjectswere current smokers or ex-smokers with a smoking history of26.1 ± 16.8 pack-years. Two thousand two hundred subjects declaredthemselves as lifelong nonsmokers. Exposure to passive smoking was notinvestigated. One thousand five hundred eighty-four subjects(14.4%) were < 40 years of age. The youngest

Discussion

In 1990, COPD ranked sixth among the most common causes of deathand is predicted to rank third by the year 2020.13Cigarette smoking is the major risk factor for COPD, inducinginflammatory changes in the airway and an protease/antiproteaseimbalance as well as an oxidant/antioxidant imbalance, leadingto irreversible damage to the most peripheral structures of the lung(emphysema).

Approximately 15 to 20% of smokers develop COPD.14 Assmoking is a behavior that can be changed, a key issue in avoiding

Appendix

Members of the Know the Age of Your Lung Study Group and theircity affiliation in Poland: M. Czajkowska-Malinowska, MD (Bydgoszcz);Z. Sankowski, MD (Koszalin); A. Kisło, MD (Suwałki); K. Krawczyk, MD (Kraków); W. Skucha, MD (Proszowice); A. Zalewska, MD(Rzeszów); W. Remiszewski, MD (Lublin); T. Kachel, MD(Bystra Ślaska); B. Cynowska, MD (Gdañsk); M. Jedrzejczak, MD (Checiny); and U. Czechowska, MD(Radom).

ACKNOWLEDGMENT

The authors thank Thomas L. Petty, MD, Master FCCP, of Denver, CO, for his inspiration and interest in the study.

References (28)

  • MG Pearson et al.

    An analysis of medical workload by specialty and diagnosis in Mersey: evidence of a specialist to patient mismatch

    J R Coll Phys Lond

    (1994)
  • DM Mannino et al.

    Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey, 1988–1994

    Arch Intern Med

    (2000)
  • American Thoracic Society

    Standardization of spirometry: 1994 update

    Am J Respir Crit Care Med

    (1995)
  • PH Quanier et al.

    Lung volumes and forced ventilatory flows

    Eur Respir J

    (1993)
  • Cited by (0)

    None of the authors have any financial involvement with BoehringerIngelheim, which supported the study.

    A complete list of investigators of the Know the Age of Your Lung Study Group is located in the Appendix.

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