Chronic Obstructive Pulmonary Disease (COPD) is largely an avoidable disease. There is a genetic form of the disease, but the lion-share is brought on by smoking tobacco. I have treated thousands of patients who have or had COPD. Every one of them smoked cigarettes. They all told me how much they regretted smoking and wished someone had told them the truth about it long ago when they first started the habit.
There is an idea in medicine, where physicians and clinics hope to catch patients early, before COPD becomes the debilitating, progressive disease that it is. One thought, is to have general practitioners or family doctors, screen patients for COPD. This is a double sided coin, because if they test a smoking patient and they don't show signs of damage, then they might not think they're at risk and continue to smoke. On the other hand, if they are tested and show disease, they might think it's too late for them and throw their hands up in the air and keep right on smoking. Sometimes, you never know how people will react to information.
The International Journal of Chronic Obstructive Pulmonary Disease looked at this very question in their article, "Early detection of COPD in general practice" by Ulrik, et al. They recruited subjects who did not have a previous diagnosis of COPD, >35 years of exposure and they had to have at least 1 respiratory symptom, like shortness of breath, cough, wheezing, recurrent respiratory infections, or sputum. More than a third of the participants had airway obstruction.
The researchers conclude that it is not difficult to screen patients for airway obstruction if you have sound prescreening criteria. The question then becomes, will those patients listen to the physician and will this information be enough motivation to get them to stop smoking? Only time will tell, as this type of initiative has strong support within the pulmonary and critical care community.
Hopefully these type of screening programs will have an enormous influence on reducing the morbidity/mortality of COPD.
