Simple lung test in doctor's office could save lives
04/20/00
NEW YORK, Apr 20 (Reuters Health) -- A simple test of lung function in the doctor's office can detect serious lung disease early in smokers, saving lives and healthcare costs, US researchers report.
Office spirometry, a quick, simple lung function test performed in the doctor's office, is especially helpful for detecting the early signs of lung disease in smokers age 45 and over.
Chronic obstructive pulmonary disease (COPD) -- a lung condition marked by progressive breathing difficulties -- affects at least 16 million people and is the fourth leading cause of death in the United States, according to Dr. Gary Ferguson of Botsford Pulmonary Associates in Framington Hills, Michigan, and colleagues in the National Lung Health Education Program (NLHEP).
Spirometry involves breathing into a machine that assesses lung function. Office spirometry can detect early signs of COPD, the authors explain, and abnormal results strongly predict rapid worsening of COPD.
The risk of COPD and the odds of having an abnormal lung test are much higher in people who smoke cigarettes. Compared with people who have never smoked, the investigators note, abnormal spirometry is five times more common in current smokers who are at least 45 years old, and three times more common in former smokers age 55 years or older.
In light of this evidence, the researchers from NLHEP recommend office spirometry for patients age 45 years and older who smoke cigarettes (or who stopped within the past year), even if they are having no breathing problems. Their recommendations are detailed in the April issue of the journal Chest.
Abnormal spirometry results should spur a patient to join a smoking cessation program, the authors advise. Once a person stops smoking, the decline in lung function eventually improves to that seen with normal aging.
Lung testing itself has been shown to enhance the rates of smoking cessation, the report indicates. ``Even a 1% to 2% improvement in smoking cessation rates would result in a very large absolute number of lives saved each year in the United States,'' the committee asserts.
``Future research may determine that other interventions, such as anti-inflammatory therapy, are effective in selected patients with airway obstruction,'' the researchers write.
But in order for any treatment to be effective, COPD must be detected early to allow interventions at a stage where improvement is still possible. Office spirometry offers the best chance of early detection, the authors conclude.
The panel also recommends office spirometry tests for any patients who have respiratory symptoms, as a way of detecting asthma or COPD, and for patients who want a thorough health assessment.