Prevalence of undiagnosed and undertreated chronic obstructive pulmonary disease in lung cancer population.
OBJECTIVE
Chronic obstructive pulmonary disease (COPD) is a risk factor and important coexisting disease for lung cancer; however, the current status of management of COPD in lung cancer patients is not fully described. This study addressed this issue in a general teaching hospital in China.


METHODS
Medical records of hospitalized lung cancer patients in Zhongshan Hospital, Fudan University, between January 2006 and December 2010 were reviewed. The definition of COPD was according to the spirometric criteria of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) document. The diagnostic rate (COPD recorded as a discharge diagnosis/spirometry-defined percentage) and conformity to GOLD treatment guidelines were investigated. The factors influencing diagnosis were analysed.


RESULTS
During the study period, the prevalence of spirometry-defined COPD in hospitalized lung cancer patients was 21.6% (705/3263). The overall diagnostic rate of COPD was 7.1%, and the treatment conformity for stable and acute exacerbation of COPD was 27.1% and 46.8%, respectively. Respiratory physicians had a higher diagnostic rate than non-respiratory doctors (34.8% vs 2.9%, P < 0.001) and a better treatment conformity for acute exacerbation of COPD (63.6% vs 37.5%, P = 0.048). Patients with COPD as a discharge diagnosis had more chance to receive guideline-consistent treatment. The diagnostic rate of COPD was higher among patients with a history of smoking, respiratory diseases or symptoms.


CONCLUSIONS
COPD is substantially underdiagnosed and undertreated in a hospitalized lung cancer population. History of smoking, respiratory diseases and symptoms promotes diagnosis. Education of COPD knowledge among patients and doctors is urgently required in this special population.
Departments of Pulmonary Medicine             Thoracic Surgery, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Jing
J
Zhang
Jie-bai
JB
Zhou
Xin-feng
XF
Lin
Qun
Q
Wang
Chun-xue
CX
Bai
Qun-ying
QY
Hong
D000368:Aged; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D019468:Disease Management; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D013147:Spirometry