The US Preventive Services Task Force (USPSTF) does not recommend screening for COPD in persons who do not have symptoms suggestive of the disease, according to a report in the April 5 issue of JAMA. This is a ‘D’ recommendation, indicating that there is moderate or high certainty that screening has no net benefit or that the harms outweigh the benefits.
The USPSTF is an independent, volunteer panel of experts that makes recommendations about the effectiveness of specific preventive care services such as screenings, counseling services, and preventive medications.
To update its 2008 recommendation, the USPSTF reviewed the evidence on whether screening for COPD in asymptomatic adults (those who do not recognize or report respiratory symptoms) improves health outcomes. The USPSTF reviewed the diagnostic accuracy of screening tools (including prescreening questionnaires and spirometry [a test of the air capacity of the lungs]); whether screening for COPD improves the delivery and uptake of targeted preventive services, such as smoking cessation or relevant immunizations; and the possible harms of screening for and treatment of mild to moderate COPD.
According to results, the USPSTF found inadequate evidence that screening for COPD in asymptomatic persons using questionnaires or spirometry improves health outcomes.
In addition, the USPSTF found inadequate evidence on the harms of screening. However, given the lack of benefit of early detection and treatment, the opportunity cost associated with screening asymptomatic persons may be large. The amount of time and effort required to screen for COPD in asymptomatic persons (using screening spirometry with or without prescreening questionnaires) is not trivial.
Similar to 2008, the USPSTF did not find evidence that screening for COPD in asymptomatic persons improves health-related quality of life, morbidity, or mortality. The USPSTF determined that early detection of COPD, before the development of symptoms, does not alter the course of the disease or improve patient outcomes. The USPSTF concluded with moderate certainty that screening for COPD in asymptomatic persons has no net benefit.
I totally disagree with this new report that screening for COPD is without benefit. Doing PFT’s on suspect COPD patients gives them incentive to quit smoking, and smoking cessation, gives the patients,the much needed tools to quit.
Using this logic, we should not be measuring blood pressure, heart rate, screening for breast or colon cancer until patients become symptomatic.