PT - JOURNAL ARTICLE AU - Roeland MM Geijer AU - Alfred PE Sachs AU - Theo JM Verheij AU - Philippe L Salomé AU - Jan-Willem J Lammers AU - Arno W Hoes TI - Incidence and determinants of moderate COPD (GOLD II) in male smokers aged 40–65 years: 5-year follow up DP - 2006 Sep 01 TA - British Journal of General Practice PG - 656--661 VI - 56 IP - 530 4099 - http://bjgp.org/content/56/530/656.short 4100 - http://bjgp.org/content/56/530/656.full SO - Br J Gen Pract2006 Sep 01; 56 AB - Background Chronic obstructive pulmonary disease (COPD) is a major health problem with an estimated prevalence of 10–15% among smokers. The incidence of moderate COPD, as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), is largely unknown.Aim To determine the cumulative incidence of moderate COPD (forced expiratory volume in 1 second/forced vital capacity ratio [FEV1/FVC] <0.7 and FEV1 <80% predicted) and its association with patient characteristics in a cohort of male smokers.Design Prospective cohort study.Setting The city of IJsselstein, a small town in the Netherlands.Method Smokers aged 40–65 years who were registered with local GPs, participated in a study to identify undetected COPD. Baseline measurements were taken in 1998 of 399 smokers with normal spirometry (n = 292) or mild COPD (FEV1/FVC <0.7 and FEV1 ≥80% predicted, n = 107) and follow-up measurements were conducted in 2003.Results After a mean follow-up of 5.2 years, 33 participants developed moderate COPD (GOLD II). This showed an estimated cumulative incidence of 8.3% (95% CI = 5.8 to 11.4) and a mean annual incidence of 1.6%. No participant developed severe airflow obstruction. The risk of developing moderate COPD in smokers with baseline mild COPD (GOLD I) was five times higher than in those with baseline normal spirometry (one in five versus one in 25).Conclusions In a cohort of middle-aged male smokers, the estimated cumulative incidence of moderate COPD (GOLD II) over 5 years was relatively high (8.3%). Age, childhood smoking, cough, and one or more GP contacts for lower respiratory tract problems were independently associated with incident moderate COPD.