Early detection of COPD in primary care: screening by invitation of smokers aged 40 to 55 years.

Abstract

BACKGROUND: The incidence of chronic obstructive pulmonary disease (COPD) is increasing in developed countries, as is the mortality rate. The main cause of COPD is smoking, and COPD is usually diagnosed at a late stage. AIM: To evaluate a method to detect COPD at an early stage in smokers in a young age group (40-55 years). DESIGN OF STUDY: Prospective descriptive study. SETTING: The city of Motala (45,000 inhabitants) and its surrounding rural areas (43,000 inhabitants) in south-east Sweden. Nineteen thousand, seven hundred and fifty subjects were between 40 and 55 years of age. According to Swedish statistics, approximately 27% of this population are smokers. METHOD: Smokers aged between 40 and 55 years were invited to have free spirometry testing in primary healthcare centres. Placards were placed in pharmacies and health centres and advertising was carried out locally twice a year. RESULTS: A total of 512 smokers responded. The prevalence of COPD was 27% (n = 141). The COPD was classified as mild obstruction in 85% (n = 120), moderate in 13% (n = 18) and severe in 2% (n = 3) according to the European Respiratory Society classification. Knowledge of the disease COPD was acknowledged by 39% of the responders to the questionnaire. Logistic regression analysis showed that age, male sex, number of pack years, dyspnoea and symptoms of chronic bronchitis significantly increased the odds of having COPD. The adjusted odds ratio was significant for having > 30 pack years. CONCLUSIONS: This method of inviting relatively young smokers selected a population of smokers with a high incidence of COPD, and may be one way of identifying smokers with COPD in the early stages.