Underestimation of respiratory symptoms by smokers: a thorn in chronic obstructive pulmonary disease diagnosis

Abstract

Primary care centers are ideal positions to identify chronic obstructive pulmonary disease (COPD). We determined the COPD prevalence among ever-smokers aged 40–65 years attending a 2-year program conducted in 22 Greek primary healthcare centers and made comparisons between genders, patients less than or greater than 55 years, and newly or previously diagnosed COPD patients. A total of 117 persons, after studying 1100 people, were diagnosed with previously unknown or known COPD, providing a COPD prevalence of 10.6% among the study population. In all, 7.5% of the participants were newly diagnosed with COPD. Women with COPD reported smoking less but experienced worse respiratory and depressive symptoms than men. A total of 19% of the COPD population below 55 years experienced wheezing and exacerbations more frequently than older patients. Newly diagnosed COPD patients were significantly younger, reported a significant burden of symptoms without seeking medical help. Primary health care has a crucial role in the early detection of COPD among unsuspecting smokers.

The Alonissos Study: Cross-Sectional Study of the Community Respiratory Health Status in a Greek Healthcare Access Underprivileged Island

“…COPD is substantially underdiagnosed, with only 10–15% of all cases identified globally [ 20 ]. In a recent study in the Greek rural population aged 40–65, it was verified that the respiratory symptoms of smokers were underestimated and thus not diagnosed as COPD cases, suggesting that the actual COPD prevalence in Greece may be even higher [ 11 ].…”

“…The spirometry procedure was conducted as previously outlined in studies in the community by our research team [ 11 ]. More specifically, the spirometry test was performed with a dry spirometer (Spirolab FCC ID: TUK-MIR045) according to the American Thoracic Society’s recommendations [ 12 ].…”

“…A bronchodilator reversibility test with 400 µg of salbutamol was performed in all patients with baseline prebronchodilator obstructive spirometry. A positive response to bronchodilators was defined as an increase in the FEV1 or FVC of 200 mL and 12% from the prebronchodilator value (baseline value) [ 11 , 14 , 16 ]. All participants with a positive bronchodilator response were excluded from the analyses.…”

Fractional Dynamics Foster Deep Learning of COPD Stage Prediction

“…Not surprisingly, 14.5% of the newly diagnosed COPD population was reported as asymptomatic in primary care clinics. [ 81 ] Also, there is a high prevalence of COPD among smokers with no symptoms. [ 82 ] Subjectively reported or observed clinical symptoms were not considered; instead, the analysis is based only on objectively measured parameters (i.e., physiological signals).…”