07 Apr Task Force Recommends Against Routine COPD Screening in Asymptomatic Adults
MedicalResearch.com Interview with:
Dr. William Phillips MD MPH
USPSTF Task Force member and
Theodore J. Phillips Endowed Professor in Family Medicine
University of Washington, Seattle. Dr. Phillips is also a founder and senior associate editor of the Annals of Family Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Phillips: Chronic obstructive respiratory disease, or COPD, is a serious, chronic condition that affects a person’s ability to breathe. It is the third leading cause of death in the United States. When the Task Force reviewed the research on screening adults for COPD in a primary care setting, we concluded with moderate certainty that screening has no net benefit, which is why we do not recommend screening for COPD in people who do not have symptoms.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Phillips: This recommendation statement applies to adults who do not recognize or report respiratory symptoms. Clinicians should use their judgment when deciding how to evaluate and treat people who have cough or other respiratory symptoms. Patients who are experiencing these symptoms are encouraged to consult their doctor.
It is important to know that the risk of developing COPD is higher for individuals who smoke cigarettes or inhale pollutants, toxic fumes, or environmental pollution, such as wood smoke or traffic pollutants. More than 70 percent of COPD cases occur among current or former cigarette smokers. The Task Force recommends that clinicians should ask all patients if they smoke and advise people who smoke to quit. Patients who smoke should receive smoking cessation counseling and be offered behavioral and pharmacologic therapies to help them stop smoking.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Phillips: When looking at the research to update this recommendation, the Task Force noted that there is a lack of data on long-term outcomes of screening for COPD. Research on COPD needs to focus particularly on current and former smokers. More research is also needed to understand the long-term outcomes of screen-detected patients who receive early treatment for COPD.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Phillips: Because most COPD cases occur among cigarette smokers, clinicians who are concerned about COPD should do what they can to help their patients quit smoking. In 2015, the Task Force issued a related recommendation on ‘Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions,’ which recommended that clinicians ask all adults about tobacco use, advise them to stop using tobacco, and provide behavioral interventions and U.S. Food and Drug Administration (FDA)–approved pharmacotherapy for cessation to adults who use tobacco.
US Preventive Services Task Force (USPSTF). Screening for Chronic Obstructive Pulmonary Disease: US Preventive Services Task Force Recommendation Statement.JAMA. 2016;315(13):1372-1377. doi:10.1001/jama.2016.2638.