Smokers aren't usually screened for chronic obstructive pulmonary disease (COPD) if they don't have symptoms, but that could change. A new study shows it's possible to identify smokers with or at risk for COPD whose lung function is likely to deteriorate rapidly—a group that might benefit from early treatment.

The investigators looked at the association between spirometric measures—FEV1 and the FEV1/FVC ratio—and the five-year rate of lung deterioration and the 12-year mortality rate in 5,887 people in the Lung Health Study. All of the participants had mild to moderate airflow obstruction (early COPD), were between the ages of 35 and 60 years, and were active smokers when they enrolled in the study.

People with lower lung function by either metric had more rapid FEV1 decline than others. Those with the worst lung function at the start of the study (FEV1/FVC ratio less than 65 percent of predicted value) had the most rapid worsening of lung function over five years, and those with a ratio of 55 percent or less had the highest risk of death over the course of the study. The most accelerated decline occurred in people who continued to smoke.

These findings suggest that smokers may need to be screened for COPD more aggressively than current guidelines recommend—and they give smokers one more reason to quit.

Source: American Journal of Respiratory and Critical Care Medicine, Volume 185, page 1301, June 2012

Publication Review By: Peter B. Terry, M.D., M.A.

Published: 07 Aug 2013

Last Modified: 07 Aug 2013