Early detection of COPD in primary care -The Copenhagen COPD Screening Project

Subjects aged 65 years and older registered with a General Practitioner (GP) in the eastern Copenhagen will receive a written invitation and a simple questionnaire focusing on risk factors and symptoms of COPD. Subjects who meet the following criteria will be encouraged to undergo spirometric testing at their GP: current smokers, former smokers, and subjects with no smoking history but who have dyspnea and/or chronic cough with sputum.The Copenhagen COPD Screening Project evaluates the effectiveness of a two-stage screening program for COPD in general practice and provides important information on how to organize early detection of COPD in general practice in the future.Chronic Obstructive Pulmonary Disease (COPD) is among the leading causes of chronic morbidity and mortality throughout the world. In 2002, COPD was the fifth leading cause of death in the world, and further increases in its prevalence and mortality are predicted [1-4]. COPD is characterised by a slowly progressing airflow limitation caused by chronic inflammation in the bronchioles. Early-stage COPD is often symptomless, although coughing with sputum production is common. Smoking is by far the most important risk factor, accounting for 85-90% of all cases [3,4]. According to recent studies, at least 25% of smokers without initial disease will have clinically significant COPD after 25 years [5-8].Early detection of COPD is crucial for promoting smoking cessation and instituting pharmacological and non-pharmacological therapy before patients reach symptomatic and costly stages of disease. Smoking cessation is followed by a marked reduction in the irreversible accelerated decline in FEV1 (forced expiratory volume in first second) associated with the development of the disease [3,4]. Even though current consensus guidelines, such as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and other national recommendations, emphasize the importance of early detection, delay in diagnosing COPD is