The U.S. Preventative Services Task Force: What You Should Know
As you know, COPD diagnosis rates are disturbingly low and as a result, the National Institutes of Health estimate that nearly half of the 30 million Americans with COPD are undiagnosed and unaware of their condition. You may also know the COPD Foundation fights tireless to increase screenings, raise public awareness, and most importantly, improve early diagnosis.
An early diagnosis can change patient’s lives as we at the COPDF have seen firsthand. Getting a diagnosis can be the motivation you needed to finally start using that treadmill or it could mean finally having a name for the symptoms you’ve been living with for years. It could connect you with a dynamite pulmonary rehab team or introduce you to your new best friends in your COPD support group. A COPD diagnosis changes lives and because of our commitment to early COPD diagnosis we were disappointed at the U.S. Preventative Services Task Force’s (USPSTF) recent report this spring recommending against screening for COPD in those who do not display symptoms.
This recent recommendation is shortsighted in its claim that neither early screenings nor available treatment options would alter the course of the disease. As many of you know, this is simply not true. This claim fails to treat a person instead of a disease. COPD treatments such as supplemental oxygen, bronchodilators and inhaled steroids can reduce the symptoms of COPD therefore allowing individuals to continue to live healthy, productive lives. An early diagnosis could mean the difference between continuing to work thanks to disease management strategies learned from your respiratory therapists or finally having the exacerbation that pushes you to file for disability rather than have another attack at work. A diagnosis encourages individuals and their families to become engaged with the patient’s health by learning more about living with COPD and options available to help them manage. Without a diagnosis, too many patients simply stop doing the activities they love in an effort simply to breathe. A diagnosis gives COPD patients the knowledge and tools to manage their disease.
Dr. Byron M. Thomashow, COPD Foundation board member and Chief Pulmonologist at Columbia University Hospital stated that patient education is important in management of individuals diagnosed with COPD. "Timely diagnosis is very important as this disease has the ability to progress quickly...," he added, "…early treatment of COPD symptoms will improve the quality of life of the individual."
As Dr. Thomashow mentions, COPD is a progressive disease. An early diagnosis, before an at-risk individual is symptomatic, could help them shed bad habits like inactivity, poor diet, and smoking, while at the same time, introducing new lifestyle management techniques such as pursed lips breathing and daily exercise to help reduce exacerbations. This is why early screening efforts should be made for at- risk populations. For a smoker in their forties, a diagnosis before they are symptomatic could save his or her life. But COPD is more than a smoker’s disease. Alpha-1 anti-trypsin deficiency is a rare genetic form of COPD that could display erratic or unusual symptoms, such as liver problems, that ordinary individuals may ignore or attribute to other issues. This could mean going years, sometimes even a lifetime, without a proper diagnosis. This is time wasted for many patients who could have been managing their disease instead of just living with it.
We applaud doctors Fernando J. Martinez, MD, MS and George T. O’Connor, MD, MS for their editorial challenging the recommendation in which they site, several “[Current available therapies] that have been shown to improve multiple measures of disease burden.” They also mention how common it is for patients to overlook or disregard symptoms that may be progressing slowly over the years. Many people with early COPD dismiss early breathlessness as old age or simply being unable to do what they use to. Without preemptive screenings these individuals could go years without a proper diagnosis, causing them to scale back their activities, go without treatment, and allow the disease to progress, unchecked.
We hope the USPSTF will reconsider its recommendation against preventative screenings in asymptomatic individuals. Early screenings are vital to preserving quality of life and peace of mind as symptoms can be mild and go largely unreported. The COPD Foundation will continue to work with the USPSTF and other community partners to raise awareness, improve diagnosis rates, and, one day, find a cure.