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Underdiagnoses of COPD common across the world

More than 75% of participants from a multinational study received an underdiagnoses of COPD, according to study results.

Bernd Lamprecht, MD, of the department of pulmonary medicine at Kepler University Hospital in Austria, and colleagues analyzed representative samples of 30,874 adults aged 40 years and older to assess the amount of COPD underdiagnoses.

Participant data came from four epidemiologic surveys including the Burden of Obstructive Lung Disease, the Epidemiologic Study of COPD in Spain, the Latin American Project for the Investigation of Obstructive Lung Disease, and the Prevalence study of COPD in Colombia.

Only 26.4% of all the participants reported undergoing a previous lung function test and 5% reported a diagnosis of COPD.

The researchers identified that 81.4% of COPD cases went undiagnosed by a physician with the highest rate occurring in Ile-Ife, Nigeria (98.3%).

While the majority of the participants with spriometrically defined COPD went undiagnosed, only 36.4% of participants with a self-reported diagnosis of COPD had post-bronchodilator airways obstruction.

In a multivariate analysis, male sex (OR = 1.5; 95% CI, 1.2-1.9), participants aged 40 to 49 years (OR = 3; 95% CI, 2-4.7), current smoking (OR = 1.5; 95% CI, 1.1-2) and no previous experience of spirometry (OR = 4.5; 95% CI, 3.6-5.8) were associated with an increased risk for COPD underdiagnoses.    

The researchers acknowledged several limitations to the study including the geographical and societal differences.

“Countries assessed are in different stages of the tobacco epidemic, perhaps even by region, and other risk factors might also have a variable distribution, for instance biomass exposure or occupational exposure,” the researchers wrote.

Further research on attempts to reduce the underdiagnoses of COPD are needed, the researchers wrote.

“Apart from primary care as the central venue to screen for COPD, other options might be considered like community pharmacies, or actively searching for COPD associated with the presence of comorbid disease,” the researchers wrote. “With some caveats for extrapolation elsewhere, the Finnish National Prevention and Treatment Programme for Chronic Bronchitis and COPD could be considered. This program encouraged the widespread use of spirometry testing combined with smoking cessation efforts and has already demonstrated a reduction in smoking prevalence and hospitalizations for COPD.” – by Ryan McDonald

Disclosure: The researchers report no relevant financial disclosures.