Determinants of underdiagnosis of COPD in national and international surveys

Lamprecht, B; Soriano, JB; Studnicka, M; Kaiser, B; Vanfleteren, LE; Gnatiuc, L; Burney, P; Miravitlles, M; García-Rio, F; Akbari, K; Ancochea, J; Menezes, AM; Perez-Padilla, R; Montes de Oca, M; Torres-Duque, CA; Caballero, A; González-García, M; Buist, S

Journal article

Determinants of underdiagnosis of COPD in national and international surveys

Abstract:: Background: COPD ranks within the top three causes of mortality in the global burden of disease, yet it remains largely underdiagnosed. We assessed the underdiagnosis of COPD and its determinants in national and international surveys of general populations.

Methods: We analyzed representative samples of adults aged ≥ 40 years randomly selected from well-defined administrative areas worldwide (44 sites from 27 countries). Postbronchodilator FEV1/FVC < lower limit of normal (LLN) was used to define chronic airflow limitation consistent with COPD. Undiagnosed COPD was considered when participants had postbronchodilator FEV1/FVC < LLN but were not given a diagnosis of COPD.

Results: Among 30,874 participants with a mean age of 56 years, 55.8% were women, and 22.9% were current smokers. Population prevalence of (spirometrically defined) COPD ranged from 3.6% in Barranquilla, Colombia, to 19.0% in Cape Town, South Africa. Only 26.4% reported a previous lung function test, and only 5.0% reported a previous diagnosis of COPD, whereas 9.7% had a postbronchodilator FEV1/FVC < LLN. Overall, 81.4% of (spirometrically defined) COPD cases were undiagnosed, with the highest rate in Ile-Ife, Nigeria (98.3%) and the lowest rate in Lexington, Kentucky (50.0%). In multivariate analysis, a greater probability of underdiagnosis of COPD was associated with male sex, younger age, never and current smoking, lower education, no previous spirometry, and less severe airflow limitation.

Conclusions: Even with substantial heterogeneity in COPD prevalence, COPD underdiagnosis is universally high. Because effective management strategies are available for COPD, spirometry can help in the diagnosis of COPD at a stage when treatment will lead to better outcomes and improved quality of life.

Publication status:: Published

Peer review status:: Peer reviewed

Actions

Email

Email this record

Send the bibliographic details of this record to your email address.

Your Email
Please enter the email address that the record information will be sent to.

-
Your message (optional)
Please add any additional information to be included within the email.
Share
Cite

Cite this record

APA Style

Lamprecht, B., Soriano, J. B., Studnicka, M., Kaiser, B., Vanfleteren, L. E., Gnatiuc, L., Burney, P., Miravitlles, M., García-Rio, F., Akbari, K., Ancochea, J., Menezes, A. M., Perez-Padilla, R., Montes de Oca, M., Torres-Duque, C. A., Caballero, A., González-García, M., & Buist, S. (2015). Determinants of underdiagnosis of COPD in national and international surveys. Chest, 148(4), 971–985.

MLA Style

Lamprecht, B, et al. “Determinants of Underdiagnosis of COPD in National and International Surveys.” Chest, vol. 148, no. 4, 2015, pp. 971–85.

Chicago Style

Lamprecht, B, JB Soriano, M Studnicka, et al. 2015. “Determinants of Underdiagnosis of COPD in National and International Surveys.” Chest 148 (4): 971–85.
Print