Prevalence of chronic obstructive pulmonary disease in asymptomatic smokers

Sansores, Raúl H; Velázquez-Uncal, Mónica; Pérez-Bautista, Oliver; Villalba-Caloca, Jaime; Falfán-Valencia, Ramcés; Ramírez‐Venegas, Alejandra

doi:10.2147/copd.s91742

Cited by 16 publications

(19 citation statements)

References 39 publications

(44 reference statements)

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“…Although current clinical practice guidelines recommend against screening for COPD in asymptomatic individuals, 23 , 42 , 43 there are several studies that have revealed a high prevalence of COPD among smokers with minimal or no symptoms. 44 In our study, the group of asymptomatic smokers with COPD represented 1.6% of the study participants and 21% of those who had COPD. These findings are in accordance with a previous study 37 showing that the prevalence of COPD in asymptomatic smokers has been 1.5% when considering the whole group of smokers and 7% when considering the group of nonsymptomatic smokers.…”

Section: Discussionmentioning

confidence: 70%

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Missed diagnosis and overtreatment of COPD among smoking primary care population in Central Greece: old problems persist

Stafyla¹,

Kotsiou²,

Deskata³

et al. 2018

COPD

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BackgroundThe diagnosis of COPD is not always consistent with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy in daily clinical practice, especially in primary care. This study aimed to estimate the overall COPD prevalence and severity, to identify differences between newly and previously diagnosed patients, and to evaluate the potential COPD overtreatment in a smoking population attending a primary care spirometry surveillance program.MethodsA study was conducted in 10 primary health care centers of Central Greece during a 7-month period. Eligible participants were aged ≥40 years and were either current smokers or exsmokers.ResultsA total of 186 subjects were included (68% males, mean age 62.3±12.6 years, mean life-time tobacco exposure 50 pack-years). COPD prevalence was 17.8%, identified to be higher in elderly males. Forty-two percent of the COPD group were newly diagnosed patients, who were of younger age, current smokers, presented with less dyspnea and better health status, and mainly appeared with mild-to-moderate disease. Interestingly, 61.4% of non-COPD and 85.7% of newly diagnosed COPD individuals had been using inhaled medication under primary care provider’s prescription without ever undergoing spirometry or further evaluation by a pulmonologist; thus, the phenomena of COPD overdiagnosis and missed diagnosis came into the spotlight. Moreover, only 26.3% of known COPD patients were properly medicated according to GOLD guidelines, while half of them were inappropriately treated with triple inhaled therapy.ConclusionWe reported a significant prevalence of COPD in smoking population attending this spirometry program. A remarkable proportion of COPD patients were undiagnosed and made case finding worthwhile. Underutilization of spirometry in the diagnosis and management of COPD as well as general practitioners’ nonadherence to the GOLD treatment guidelines was confirmed by our data. These findings highlight the need for a major overhaul and culture change in primary care settings of Central Greece.

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Section: Discussionmentioning

confidence: 70%

“…These findings are in accordance with a previous study 37 showing that the prevalence of COPD in asymptomatic smokers has been 1.5% when considering the whole group of smokers and 7% when considering the group of nonsymptomatic smokers. 44 …”

Section: Discussionmentioning

confidence: 99%

Missed diagnosis and overtreatment of COPD among smoking primary care population in Central Greece: old problems persist

Stafyla¹,

Kotsiou²,

Deskata³

et al. 2018

COPD

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“…Moreover, the American College of Chest Physicians and the European Respiratory Society do not recommend screening of asymptomatic smokers by spirometry [ 25 ]. Indeed, the incidence of COPD in asymptomatic cigarette smokers is very low [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Subtle right ventricular dysfunction in asymptomatic chronic heavy cigarette smokers: a speckle tracking case-control study

et al. 2021

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Background Chronic heavy cigarette smoking can affect the right ventriclular function. The standard echocardiography may not show early right ventricular functional changes, and a more sensitive measure is needed. The aim of this work was to evaluate the subtle subclinical effects of chronic heavy cigarette smoking on the right ventricular function. The study included 55 healthy asymptomatic chronic heavy cigarette smokers (smoking history of at least 5 pack-years and a daily cigarette consumption of at least 1 pack) and 35 healthy non-smoking control subjects. Patients underwent a full clinical assessment and a conventional as well as a 2D-speckle tracking transthoracic echocardiography of the right ventricle and data was compared between the 2 groups. Results The mean age was 32.9 ± 7.2 years in smokers and 30.9 ± 7.9 years in non-smokers (p = 0.227). The 2 groups showed comparable conventional right ventricular systolic and diastolic functions. Smokers showed a significantly lower (less negative) right ventricular global longitudinal strain (− 19.0 ± 3.2% vs. − 24.5 ± 3.5%, p < 0.001). Patients with a higher daily cigarette consumption showed a poorer right ventricular global longitudinal strain (p = 0.014). Conclusion Chronic heavy cigarette smoking can adversely affect the right ventricular function, a finding that can be easily missed by conventional echocardiography and can be better detected by the right ventricular speckle tracking.

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“…The cutoff COPD Assessment Test (CAT) score to identify this group may be derived from the value used in Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging (<10; less-symptoms group, ≥10; more-symptoms group) [69]. A previous study showed that 13.7% of smoking-related COPD patients do not have symptoms, and 1.5% of asymptomatic smokers have airway obstruction [70]. These patients are likely to be underdiagnosed, exposed continuously to risk factors, especially tobacco smoking, and progress to overt COPD.…”

Section: Definitionmentioning

confidence: 99%

Diagnosis and Treatment of Early Chronic Obstructive Lung Disease (COPD)

Choi

Rhee

2020

JCM

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Chronic obstructive lung disease (COPD) is responsible for substantial rates of mortality and economic burden, and is one of the most important public-health concerns. As the disease characteristics include irreversible airway obstruction and progressive lung function decline, there has been a great deal of interest in detection at the early stages of COPD during the “at risk” or undiagnosed preclinical stage to prevent the disease from progressing to the overt stage. Previous studies have used various definitions of early COPD, and the term mild COPD has also often been used. There has been a great deal of recent effort to establish a definition of early COPD, but comprehensive evaluation is still required, including identification of risk factors, various physiological and radiological tests, and clinical manifestations for diagnosis of early COPD, considering the heterogeneity of the disease. The treatment of early COPD should be considered from the perspective of prevention of disease progression and management of clinical deterioration. There has been a lack of studies on this topic as the definition of early COPD has been proposed only recently, and therefore further clinical studies are needed.

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Prevalence of chronic obstructive pulmonary disease in asymptomatic smokers

Cited by 16 publications

References 39 publications

Missed diagnosis and overtreatment of COPD among smoking primary care population in Central Greece: old problems persist

Missed diagnosis and overtreatment of COPD among smoking primary care population in Central Greece: old problems persist

Subtle right ventricular dysfunction in asymptomatic chronic heavy cigarette smokers: a speckle tracking case-control study

Diagnosis and Treatment of Early Chronic Obstructive Lung Disease (COPD)

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