USPSTF recommends against screening for COPD in asymptomatic adults

The USPSTF recommends against screening asymptomatic adults for COPD in primary care.
The USPSTF recommends against screening asymptomatic adults for COPD in primary care.

Screening for chronic obstructive pulmonary disease (COPD) in asymptomatic adults is not recommended, according to a recommendation statement from the U.S. Preventive Services Task Force (USPSTF) published in JAMA.

Based on the available evidence, the USPSTF determined that early detection of COPD (before a patient develops symptoms) does not change the disease's course or improve outcomes.

The USPSTF has categorized this as a D recommendation, meaning that there is moderate to high certainty that there is no net benefit or that the harms outweigh the benefits.

Adults can be screened for COPD through two methods:

  1. Risk assessment through a formal prescreening questionnaire; if positive, follow-up diagnostic spirometry testing
  2. Screening spirometry administered without a bronchodilator; if positive, follow-up with diagnostic spirometry testing

The USPSTF found inadequate evidence that screening asymptomatic adults for COPD via either of these methods benefits health outcomes. The task force also found inadequate evidence regarding the harms of screening, but the lack of benefits may mean that the opportunity cost of screening may be large.

Treatment trials for COPD found that medication decreases the exacerbation of COPD symptoms in patients with mild to moderate COPD. However, none of these trials included asymptomatic patients – even so, the USPSTF states that it is unclear how treatment benefits would apply to patients who do not have any symptoms.

The recommendation is an update to the USPSTF's 2008 statement, in which the group advised that asymptomatic adults should not be screened for COPD with spirometry.

Reference

  1. US Preventive Services Task Force. Screening for Chronic Obstructive Pulmonary Disease: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(13):1372-1377.
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