Researchers have found that screening all smokers for COPD using spirometry may be more useful than a symptom-based approach.

“Despite current and updated GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines that recommend case-finding studies for early diagnosis of COPD, the present study showed that a screening program aimed at all smokers may also be a positive strategy if economic resources are available,” the authors wrote.

For the study, 1999 participants underwent spirometry after reporting symptoms of cough, phlegm, wheezing, and shortness of breath; another 782 participants were recruited from a smoking cessation program. All participants were current or former smokers with a cumulative past consumption of at least 10 pack-years.

A significantly greater proportion of participants (13.3%) in the screening group were classified as having COPD according to the GOLD classification, compared to 10.1% in the symptom-based group. Dyspnea was the most common symptom in the two groups, occurring in 56% in the symptom-based group and 55% in the screening group.

The authors believe the lack of spirometry testing on smokers or patients presenting with symptoms has led to an underestimation of the worldwide prevalence of COPD, as well as missed opportunities for early treatment.

“All lines of evidence overwhelmingly demonstrate that the identification of smokers (with or without symptoms) may also be useful, not only to detect an important number of smokers with COPD but also to increase awareness about COPD, to prevent its development, to encourage smoking cessation and to decrease the potential risk of death,” they concluded.