Millions of Americans have COPD, some diagnosed, some not

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Millions of Americans have already been diagnosed with chronic obstructive pulmonary disease (COPD). Millions more remain undiagnosed and are at serious risk for health complications. Questions, conversation, and education in the clinical setting facilitate early detection and improve outcomes.


Chronic obstructive pulmonary disease (COPD) is a slowly progressive condition of the airways characterized by a gradual loss of lung function. "The National Health and Nutrition Evaluation Survey III (NHANES III) estimated that 16 million people carry a diagnosis of COPD as diagnosed by physicians or healthcare workers, 2.2 million of which have emphysema while the rest have chronic obstructive bronchitis," says Dennis E. Doherty, MD, FCCP. "Some studies have suggested that millions more have the disease. Based on the data from NHANES III, it is estimated that between 45 and 50 million people have the disease, and that as many as two-thirds of those individuals are not yet diagnosed or do not know that they carry the diagnosis."


Dr. Doherty says patient-provider communication issues contribute to COPD underdiagnosis. Fears and misconceptions often make patients reluctant to discuss their symptoms. Physicians may need to seize the communication initiative.

"Over 85% of all COPD is caused by smoking tobacco, but many patients don't want to quit smoking and they won't tell their physician about their habit," he says. "But we need to be asking our patients questions about their habits. We also must remember to check for genetic predispositions. A deficiency of alpha- 1 antitrypsin places people at an increased risk to develop COPD."


Other research has indicated that COPD is misdiagnosed as asthma, especially in women, according to Dr. Doherty.

"Patients may feel less apprehensive about an asthma diagnosis because there isn't a stigma attached to it like COPD. Even though the majority of COPD cases tend to be mild rather than severe, patients still think it is a death sentence. The disease is partially reversible, especially during its earlier stages. Patients may not get back their normal lung function with treatment, but lung function, quality of life, and activities of daily living can improve with proper pharmacologic and non-pharmacologic therapies."
CONTINUES.........Physician's Weekly