Surveillance of chronic obstructive pulmonary disease in high-risk individuals by using regional lung cancer mass screening

Abstract

Background and objectivePatients with chronic obstructive pulmonary disease (COPD) are at risk for lung cancer; the diseases have common etiologies, including cigarette smoking. We aimed to clarify the effectiveness of COPD detection using a regional mass-screening program for lung cancer.Materials and methodsA total of 7,067 residents of Togane, Chiba, Japan received lung cancer screening between May and July, 2011. We defined four groups of possible COPD candidates: group A (n=358), positive smoking history, positive chronic respiratory symptoms; group B (n=766), positive smoking history, positive lifestyle-related disease; group C (n=75), passive smoking history, positive chronic respiratory symptoms; and group D (n=301), passive smoking history, positive lifestyle-related disease. Candidates underwent on-site pulmonary function testing (PFT).ResultsThe criteria for COPD candidates were fulfilled in 1,686 of 7,067 individuals (23.9%); 1,500 participants underwent PFT (89%), and 171 (11.4%) were diagnosed with COPD. The overall COPD detection rate was 2.4%. The frequency of COPD was significantly higher in groups A and B than in groups C and D (P=0.048); however, the distribution of COPD grades was similar among the groups (P=0.372). Multiple logistic regression analysis identified male sex, age 60 years or greater, and positive smoking history as risk factors for COPD.ConclusionCOPD screening using a community-based lung cancer-screening program may be effective for disease detection. Individuals who are 60 years of age or older with a positive smoking history should undergo PFT to detect COPD.

Prevalence of undiagnosed airflow obstruction among people with a history of smoking in a primary care setting

“…The prevalence of undiagnosed AO among subjects with smoking history who participated in this study was 14.6%, which is similar to that reported in the study of Sekine et al conducted in Japan (13.1% prevalence among people with smoking history). 17 The response rate of this cross-sectional survey (97.9%) was high. Most subjects were in the older age group with a relatively low educational level, who were likely to be representative of the public primary care clinics encounters in Hong Kong.…”

“…Smokers, men, and older people have a higher risk of being affected. 15 The prevalence of undiagnosed AO among people with smoking history varies worldwide, 12 and it ranges from 10.1% in the UK, 16 13.1% in Japan, 17 and 34.8% in Denmark among smokers with chronic respiratory symptoms. 18 …”

The Importance of Appropriate Diagnosis in the Practical Management of Chronic Obstructive Pulmonary Disease

“…An evaluation of airflow limitation by spirometry examination is optional in statutory medical examinations in Japan. For the early detection of COPD, some studies evaluated airflow limitation by spirometry among subjects aged 40 years or older who had participated in community-based annual health checks in Japan [ 14 , 15 ]. The prevalence of COPD in adults, aged 40 and over, is estimated to be around 10% in Japan.…”