Many Canadian patients with debilitating lung disease aren't being diagnosed, suggests a new study, and that means many are suffering without treatment needlessly.
The research, published Tuesday in the Canadian Medical Association Journal, found that as many as 20 per cent of adults with known risk factors for chronic obstructive pulmonary disease (COPD) are currently undiagnosed yet suffer from the illness.
COPD is the relatively new name for emphysema and chronic bronchitis. It's a degenerative, incurable lung disease that's usually caused by smoking and causes shortness of breath that can't be easily relieved.
Many patients with COPD mistake its symptoms for asthma or chest infections, or think wheezing or coughing are a normal part of getting older.
For this study, researchers looked at 1,003 participants aged 40 and over who made doctor visits in Toronto, Ottawa and Sault Ste. Marie, Ont. Since 80 to 90 per cent of COPD patients are current or former smokers, the patients in the study were too; most had smoked the equivalent of a pack a day for two decades.
The researchers had the participants perform a lung function test, called spirometry, in which they blew into an apparatus that measured the flow of air going in and coming out of their lungs.
They found that one of every five of the patients had COPD.
What's more, a significant portion were unaware they had the condition: almost 70 per cent of those confirmed to have COPD had not been diagnosed with the condition before. That's despite the fact that three-quarters of the patients with COPD reported at least one respiratory symptom, such as a chronic cough, frequent colds, or shortness of breath.
The study authors say they were surprised how underdiagnosed COPD was, considering that all of the patients had two key COPD risk factors: histories of smoking; and being over the age of 40, the age when the disease tends to start to cause symptoms.
Dr. Roger Goldstein, a co-author of the study, and a respirologist at West Park Healthcare Centre in Toronto, says family doctors could be identifying and diagnosing these patients.
"These findings suggest that adults who attend a primary care practice with known risk factors for COPD are important targets for screening and early intervention," Goldstein and his coauthors write.
Goldstein notes that diagnosing patients with COPD can often give them the incentive patients need to finally quit smoking. Not only could such early diagnosis extend the lives of patients, it could cut health care costs.
"Success of early intervention in this population could result in important reductions in mortality, morbidity and health care expenditures related to COPD," the authors write.
COPD cannot be cured but it can be slowed by quitting smoking and staying away from smoky locations. There are also medications and puffers that can help with symptoms, and some patients also use supplemental oxygen.
