title: Early detection of COPD in general practice.
abstract: OBJECTIVE
  Early detection enables the possibility for interventions to reduce the future burden of COPD. The Danish National Board of Health recommends that individuals >35 years with tobacco/occupational exposure, and at least 1 respiratory symptom should be offered a spirometry to facilitate early detection of COPD. The aim, therefore, was to provide evidence for the feasibility and impact of doing spirometry in this target population.
  
  
  METHODS
  Participating general practitioners (GPs) (n = 335; 10% of the Danish GPs) recruited consecutively, subjects with >35 years exposure, no previous diagnosis of obstructive lung disease, and at least 1 of the following symptoms: cough, dyspnea, wheezing, sputum, or recurrent respiratory infection. Data on age, smoking status, pack-years, body mass index (BMI), dyspnea score (Medical Research Council, MRC), and pre-bronchodilator spirometry (FEV(1), FEV(1)% predicted, FEV(1)/FVC) were obtained.
  
  
  RESULTS
  A total of 3.095 (51% females) subjects was included: mean age 58 years, BMI 26.3, and 31.5 pack-years. The majority of subjects (88%) reported MRC score 1 or 2. FEV(1)/FVC-ratio ≤ 0.7 was found in 34.8% of the subjects; the prevalence of airway obstruction increased with age and decreased with increasing BMI, and was higher in men and current smokers. According to the level of FEV(1), 79% of the subjects with airway obstruction had mild to moderate COPD.
  
  
  CONCLUSIONS
  More than one-third of the recruited subjects had airway obstruction (FEV(1)/ FVC < 0.7). Early detection of COPD appears to be feasible through offering spirometry to adults with tobacco/occupational exposure and at least 1 respiratory symptom.
authors.affiliation: Department of Heart and Lung Diseases, Hvidovre University Hospital, Hvidovre, Denmark. csulrik@dadlnet.dk
authors.forename: Charlotte Suppli
authors.initials: CS
authors.lastname: Ulrik
authors.forename: Anders
authors.initials: A
authors.lastname: Løkke
authors.forename: Ronald
authors.initials: R
authors.lastname: Dahl
authors.forename: Jens
authors.initials: J
authors.lastname: Dollerup
authors.forename: Gert
authors.initials: G
authors.lastname: Hansen
authors.forename: Patrick Hagge
authors.initials: PH
authors.lastname: Cording
authors.forename: Klaus Kaae
authors.initials: KK
authors.lastname: Andersen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003718:Denmark / Q000453:epidemiology; D042241:Early Diagnosis; D005240:Feasibility Studies; D005260:Female; D005541:Forced Expiratory Volume; D058006:General Practice; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry; D014797:Vital Capacity