No screening evidence for COPD

Asymptomatic adults should not be screened for chronic obstructive pulmonary disease (COPD), the US Preventive Services Task Force (USPSTF) stated with moderate certainty based on evidence that there was no net benefit.

Because COPD is the 6th leading cause of death in the USA, the USPSTF re-reviewed screening evidence of asymptomatic individuals, after their D-level recommendation against screening in asymptomatic adults was originally issued in 2016. Their results and recommendations were presented by Prof. Carol Mangione (University of California at Los Angeles, CA, USA), and published in JAMA [1,2]. After a review of all new evidence, the USPSTF re-affirmed its previous recommendation that COPD civilian screening has no net benefit for asymptomatic adults.

The Task Force stressed that their recommendation only applies to adults with no respiratory symptoms; anyone with symptoms such as a chronic cough, sputum, breathing difficulties, or wheezing, should consult a specialist and take action. The USPSTF also pointed out that factors such as cigarette smoking could increase a person’s risk for COPD. Cigarette smoking is the leading cause of COPD in the USA, with approximately 15% of current smokers and 8% of former smokers reporting a diagnosis of COPD.

The Task Force reviewed new data from 6 treatment trials and 2 observational trials that focused on pharmacologic or non-pharmacologic treatment harms in adults with mild-to-moderate or minimally symptomatic COPD. Prof. Mangione noted that among the trials that reported adverse events, no significant harms were recorded.

Prof. Mangione noted that it is still unclear whether early treatment for asymptomatic, minimally symptomatic, or screen-detected populations would slow disease progression. “The USPSTF found no new substantial evidence that could change its recommendation and, therefore, re-affirms its recommendation against screening for COPD in asymptomatic adults.”

1. Mangione C, et al. Screening for Chronic Obstructive Pulmonary Disease: US Preventive Services Task Force Reaffirmation Recommendation Statement. Session A84, ATS International Conference 2022, San Francisco, CA, USA, 13–18 May.
2. US Preventive Services Task Force. JAMA. 2022;327(18):1806-1811.

 

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Posted on 18 July 2022