Early detection of COPD in a high-risk population using spirometric screening

Abstract

Study objectives: To evaluate the efficacy of mass spirometry use for the detection of airflow obstruction in a high-risk population.

Design: Free spirometry was offered to smokers who were > 39 years of age with a smoking history of > 10 pack-years. Action was preceded by the dissemination of information on the causes and symptoms of COPD in the local mass media.

Setting: Pulmonary outpatient clinics in 12 large cities of Poland.

Participants: Eleven thousand twenty-seven subjects 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 FEV(1)), and an antismoking advice.

Results: Spirometric signs of airway obstruction were found in 24.3% of the subjects who were screened. Of those subjects, mild obstruction was found in 9.5%, moderate obstruction was found in 9.6%, and severe obstruction was found in 5.2%. In smokers aged > or = 40 years who had a smoking history of > 10 pack-years, airway obstruction was found in 30.6%. Airway obstruction was present in 8.3% of smokers < 40 years of age who had a smoking history of < 10 pack-years. Of the 2,200 subjects who had never smoked in their lives, airway obstruction was found in 14.4%.

Conclusions: Mass spirometry in high-risk groups is an effective and easy method for the early detection of COPD.