Expert advises annual lung test for smokers during physical exam

May 20, 2001

A leading expert on the crippling lung illness chronic obstructive pulmonary disease (COPD) today called for smokers to take a simple lung function test (spirometry) during their annual physical exam to determine whether their respiratory system was being compromised by their cigarette habit.

Bartolome Celli, M.D., speaking at the American Thoracic Society (ATS) International Conference in San Francisco, said if the patient's lung function is affected they can get help in quitting smoking and reduce their risk of suffering from this serious lung disease. Once a patient is aware of the problem, they can also get treatment.

"Smoking cessation is the single best method and the most cost-effective way of reducing the risk of developing COPD or stopping its progression," said Dr. Celli, Professor of Medicine at Tufts University, Boston.

William J. Martin, II, M.D., Floyd and Reba Smith Professor of Medicine at the Indiana University Health Care Center and outgoing President of the ATS, said: "We need to improve the early detection of COPD by increasing the availability of a simple spirometry machine in the offices of primary care physicians. These physicians and their nurses take care of the vast majority of people at risk for COPD. Once properly diagnosed through spirometry, COPD can be effectively managed."

The two physicians joined other experts including Romaine Pauwels, MD., Professor, Department of Respiratory Diseases, Universitair Ziekkenhuis, Belgium, and Claude Lenfant, M.D., Director of the U.S. National Heart, Lung, Blood Institute to discuss the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The experts were focusing on the way the ATS can assist in GOLD's international efforts to help millions of people worldwide who suffer from this potentially crippling disease.

COPD is a term used to describe chronic bronchitis and emphysema. A slowly progressive lung disease characterized by a gradual loss of lung function, the illness is caused primarily by smoking in the U.S. and throughout most of the developed world. Victims have an abnormal inflammatory response in the lung in response to noxious particles or gasses from cigarettes and smoke. Symptoms can include cough, sputum, and phlegm even before lung function begins to decline.

COPD is the fourth leading cause of death in the U.S. behind heart disease, cancer, and stroke. By 2020, it is predicted to rank as the third leading cause of death. Approximately 100,000 men and women die from the disease annually in the U.S., a death rate representing a 22 percent increase over the past decade. The highest rate of increase in deaths has been seen in white women.

One of the experts, Dr. Lenfant, whose Institute, NHLBI, together with the World Health Organization (WHO), sponsored the GOLD Global Initiative Report, hailed the recent release of the international guidelines as a way for local medical societies in more than 100 countries throughout the world to help clinicians identify the disease and manage the condition.

Dr. Pauwels, Chair of the Workshop that produced the COPD Report, said: "COPD has received significantly inadequate attention from healthcare professionals and governments, in comparison to its impact on the world's population. In order to receive the increasing prevalence, a unified international effort is required. GOLD involves a committed team of COPD experts and medical associations from more than 100 countries and its members will personally act to bring about the needed changes in their home countries."

For the ATS, Dr. Celli is heading a committee to revise the Society's medical guidelines for physicians. His group will also establish a site on the worldwide web where patients can get the latest information about the disease. The new ATS guidelines are expected to be published within 18 months; at the same time, the patient website is expected to be up and running. ###
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American Thoracic Society

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